Substances which threaten the heart

Alcohol, tobacco, drugs — worrying figures

It’s a well-known fact — alcohol, tobacco and drugs can play a major role in the onset or recurrence of a heart rhythm disorder or heart incident, in particular atrial fibrillation. This role was quantified precisely, in particular by a very large-scale study led in 2021 by a team from Louisiana State University with 135,000 people aged under 45. It showed, for instance, that smokers are twice as likely to develop premature heart disease. The risk is 50% greater than average for people who drink alcohol. As for drugs, the figures are even higher: the risk is 2.5x greater for consumers of cocaine and cannabis, and almost 3x for amphetamines. What’s more, consuming at least four of these products leads to a 9x greater risk. 

No less worrying, the study established that patients suffering from premature heart disease are more likely to smoke (63% compared to 41% for the general population), and consume alcohol (32% compared to 15%), cocaine (13% compared to 2.5%), amphetamines (3% compared to 0.5%) and cannabis (12.5% compared to 3%). 

The effects of alcohol, tobacco and drugs on heart rhythm disorders

Alcohol, tobacco and drugs have major and specifically identified impacts on the heart.
Alcohol raises blood pressure, which increases the risk of heart diseases. And when you already suffer from such a disease, keeping blood pressure under control is essential to prevent any complications. Alcohol is also one of the factors that may cause an arrhythmia, atrial fibrillation and other heart complications such as cardiomyopathy. But unlike drugs and tobacco, alcohol consumption is not to be prohibited as long as it is in moderation, i.e. no more than two glasses per week. Be aware of received ideas, small doses of alcohol are not beneficial for heart health either. They most often have no impact. From three glasses a week, the risk is moderate. Beyond seven glasses, the risk is high. 

Tobacco is harmful from the first cigarette. It is even one of the main risk factors for heart disease and considerably reduces the chance of remission or recovery, increasing the risk of recurrence. The carbon monoxide it contains reduces the ability of the blood to transport oxygen. The heart must therefore make more effort to continue to supply enough oxygen to the body. Tobacco also damages the blood vessels, which can lead to heart attacks. By increasing blood viscosity, it can also cause blood clots, which can result in a heart attack. Tobacco indirectly influences eating habits, pushing smokers to choose foods higher in saturated fat, also known as bad fats, which exacerbate the cardiovascular risk. 

A vast study published in late 2022, involving over 23 million people and led by the University of California, measured the impact of drugs. Hospital admissions in California between 2005 and 2015 were studied: out of the 23 million patients admitted, 132,834 consumed cannabis, 98,271 consumed methamphetamine, 48,700 consumed cocaine and 10,032 consumed opiates. It appeared that the risk of atrial fibrillation increased by 35% for cannabis users, 61% for cocaine users and 74% for heroin and opiate users. The effects of these drugs are well-known. Cannabis increases the heart rate and blood pressure. Cocaine and amphetamines have the same effect. Opiates can reduce oxygen levels, which can damage the heart. 

Stopping your consumption and improving your lifestyle

Quitting alcohol, tobacco and drugs isn’t easy. It is, however, essential, even more so when you suffer from a heart rhythm disorder. But you can’t just stop like that. Withdrawal programmes must be implemented in agreement with your cardiologist. In the case of tobacco, for instance, substitutes may be offered, as well as medication. It is important not to neglect psychological support, which can be provided by therapists, support groups and associations (see box).