Counseling for Alcohol Use in Patients With Cardiovascular Disease

Alcohol is among the most used drugs, plays a large role in many societies and cultures around the world, and greatly impacts public health. Because it is a drug, pharmacists should consider counseling for alcohol use in all patients.

The World Health Federation recently released a new policy brief that called for “urgent and decisive action to take the unprecedented rise in alcohol-related death and disability worldwide.” The executive summary opens with the following sentence: “Over the past decades, the prevalence of cardiovascular diseases has nearly doubled, and alcohol has played a major role in the incidence of much of it.”

Focusing on cardiovascular disease, the policy brief in people living with cardiovascular diseases and other chronic illnesses calls for complete abstinence from alcohol. This is based on the justification that “alcohol increases the risk for hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, and strokes” (Table 1). The policy goes on to recommend advocacy from national societies and organizations (ie pharmacy organizations) for stricter alcohol control measures.

How can the individual pharmacist counsel patients about alcohol? First, patients need to understand that alcohol is a drug, not a liquid refreshment. Second, alcohol consumption has harms, including increased or decreased heart rate, muscle control difficulties, short-term memory loss, heightened emotions of sadness, anxiety, or fear, lack of concentration, and respiratory problems. Finally, for patients with documented cardiovascular disease, counseling should promote cessation of use and abstinence from alcohol.

Let us remember that alcohol is a major avoidable risk factor.

Reference:
World Heart Federation. The impact of alcohol consumption on cardiovascular health: myths and measures. Accessed February 2, 2022. https://world-heart-federation.org/wp-content/uploads/WHF-Policy-Brief-Alcohol.pdf