Binge Drinking Impairs Vascular Function in Young Adults

Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois.
Journal of the American College of Cardiology (Impact Factor: 15.34). 04/2013; 62(3). DOI: 10.1016/j.jacc.2013.03.049
Source: PubMed

ABSTRACT OBJECTIVES: The study aimed to assess whether young binge drinkers have impaired macrovascular and microvascular function and cardiovascular (CV) disease risk factors compared to age-matched alcohol abstainers. BACKGROUND: Binge drinking rates are highest on college campuses and among 18- to 25-year-olds; however, macrovascular and microvascular endothelial function in young adults with a history of repeated binge drinking (≥5 standard drinks in 2 hrs. in men; ≥4 standard drinks in 2 hrs. in women) has not been investigated METHODS: We evaluated the cardiovascular profile, brachial artery endothelial-dependent flow mediated vasodilation (FMD), and flow independent nitroglycerin (NTG)-mediated dilation and vasoreactivity of resistance arteries (isolated from gluteal fat biopsies) in abstainers and binge drinkers. RESULTS: Men and women (18-25 years of age, abstainers [A] n = 17, binge drinkers [BD] n = 19) were enrolled. Among the BD group, past-month average number of binge episodes was 6 ± 1, and average duration of binge drinking behavior was 4 ± 0.6 years. FMD and NTG-mediated dilations were significantly lower in the BD (FMD: 8.4% ± 0.7, P = 0.022; NTG: 19.6% ± 2, P = 0.009) than the A group (FMD: 11 ± 0.7%; NTG: 28.6 ± 2%). ACh- and SNP-induced dilation in resistance arteries was not significantly different between the A and BD groups. However, ET-1-induced constriction was significantly enhanced in the BD group compared to the A group (P = 0.032). No differences between groups were found in blood pressure, lipoproteins, and C-reactive protein. CONCLUSIONS: Alterations in the macrocirculation and microcirculation may represent early clinical manifestations of CV risk in otherwise healthy young binge drinkers. This study has important clinical implications for screening young adults for a repeated history of binge drinking.

Download full-text


Available from: Emily Church, May 16, 2014
  • Journal of the American College of Cardiology 04/2013; 62(3). DOI:10.1016/j.jacc.2013.03.047 · 15.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The percentage flow-mediated dilation index (FMD%) scales the increase in arterial diameter (Ddiff) as a constant proportion of baseline artery diameter (Dbase). We have demonstrated, albeit with small samples, that the scaling properties of FMD% can lead to biased inferences on endothelial dysfunction. Therefore, we aimed to investigate the underlying rationale and potential bias of FMD% using a selection of new examples from the large (n = 3499) and diverse Multi-Ethnic Study of Atherosclerosis (MESA). In this dataset, we found that smaller values of Ddiff are associated with larger values of Dbase, which contradicts the scaling properties of FMD%. Consequently, FMD% 'over-scales' and naturally generates an even stronger negative correlation between itself and Dbase. Using a data simulation, we show that this FMD%-Dbase correlation can be a statistical artefact due to inappropriate scaling. The new examples we present from MESA indicate that FMD% biases the differences in flow-mediated response between men and women, Framingham risk score categories, and diseased and healthy people. We demonstrate how FMD%, as an exposure for predicting cardiovascular disease, is confounded by its dependency on Dbase, which itself could be clinically important. This critical review, incorporating an allometric analysis of a large dataset, suggests that the FMD% index has a less-than-clear rationale, can itself generate the Dbase-dependency problem, provides biased estimates of differences in the flow-mediated response, complicates the interpretation of the flow-mediated protocol and clouds the causal pathway to vascular disease. These interpretative problems can be resolved by applying accepted allometric principles to the flow-mediated response.
    Vascular Medicine 10/2013; 18(6). DOI:10.1177/1358863X13508446 · 1.73 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Although binge drinking and high resting heart rate independently affect cardiovascular and all-cause mortality risk, the combined effect of these two risk factors and their interaction has rarely been studied. This study examined the association between binge drinking and cardiovascular and all-cause mortality and evaluated the potential modifying effect on this association of resting heart rate in Korean men.Methods: Men aged 55 years or older in 1985 (n = 2600) were followed for cardiovascular and all-cause mortality for 20.8 years, until 2005. We estimated hazard ratios (HRs) for cardiovascular and all-cause mortality by binge drinking and resting heart rate using the Cox proportional hazard model.Results: Heavy binge drinkers (≥12 drinks on one occasion) with elevated resting heart rate (≥80 bpm) had a HR of 2.25 (95% confidence interval [CI], 1.47-3.45) for death from cardiovascular disease and 1.37 (95% CI, 0.87-2.14) for all-cause mortality compared to the reference group (non-drinking and resting heart rate 61-79 bpm). The HRs of dying from cardiovascular disease increased linearly from 1.36 to 1.52, 1.71, and 2.25 among individuals with resting heart rate greater than or equal to 80 bpm within the four alcohol consumption categories (non-drinking, non-binge, moderate binge, and heavy binge), respectively.Conclusions: Our findings suggest that, among older Korean men, heavy binge drinkers with an elevated resting heart rate are at high risk for cardiovascular and all-cause mortality.
    Journal of Epidemiology 04/2014; 24(4). DOI:10.2188/jea.JE20130101 · 2.86 Impact Factor