Under the Influence: The Epidemic of Excessive Alcohol Use and Its Impact on Heart and Liver Health

Alcohol use disorder (AUD) is seen in 7% of the world population. In 2019, nearly 3 in 10 adults in the United States (US) consumed аlсоhοl in an unhealthy manner. This alcohol misuse that further increased during the coronavirus disease 2019 pandemic is now persisting, and is associated with rising rates of alcohol-associated hospitalizations, end-organ disease, death, and need for liver transplantation. The current lifetime risk of AUD in the US is estimated to be >30%, and with the steadily rising alcohol consumption in the US, this risk is expected to continue to increase. The effect of excessive alcohol on human health is associated with its lifetime cumulative use and is further impacted by factors like age, gender, nutritional status, concurrent cigarette smoking or drug use, diabetes, increased body weight, kidney disease, other cardiovascular diseases and socio-economic status. In this review we present the complex interplay between alcoholic liver and heart diseases, describing the natural history of each organ involvement and identifying risk factors that are associated with the progression of various alcohol-related end-organ diseases. Abstaining from alcohol or moderating its consumption has been shown to reduce the progression of heart failure, arrhythmias, and hypertension linked to excessive alcohol intake, as well as help prevent alcoholic liver disease. Focus on the identification of other modifiable risk factors associated with various organ injuries in conjunction with public health policies for the safe use of alcohol is needed to mitigate the risk of an impending epidemic of AUD.