Alcohol-induced autonomic dysfunction: a systematic review

Purpose Autonomic dysfunction is a known consequence of chronic and excessive alcohol consumption. The aim of this systematic review was to characterise this phenomenon, describe the frequency at which it occurs and to explore the best management strategies. Methods A systematic, computer-based sear...

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Bibliographic Details
Published in:Clinical autonomic research 2020-02, Vol.30 (1), p.29-41
Main Authors: Julian, Thomas Henry, Syeed, Rubiya, Glascow, Nicholas, Zis, Panagiotis
Format: Article
Language:English
Subjects:
Alcohol
Cardiology
Case reports
Diabetes
Dysautonomia
Endocrinology
Erectile dysfunction
Ethanol
Gastroenterology
Health risk assessment
Medicine
Medicine & Public Health
Neurology
Ophthalmology
Population studies
Review
Review Article
Reviews
Risk factors
Systematic review
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Summary:Purpose Autonomic dysfunction is a known consequence of chronic and excessive alcohol consumption. The aim of this systematic review was to characterise this phenomenon, describe the frequency at which it occurs and to explore the best management strategies. Methods A systematic, computer-based search was conducted using the PubMed database. All studies identified by the search were evaluated independently by at least three authors. For inclusion, studies had to report human subjects consuming ethanol in excess. Case reports and non-original studies were excluded from this review. Results A total of 55 studies were included in this review. According to cardiovascular reflex tests, 16–73% of chronic alcohol abusers suffer from autonomic dysfunction. The most commonly occurring symptom is erectile dysfunction, whilst other features such as postural dizziness are rare. The most important risk factor for this condition is total lifetime dose of ethanol, although there is mixed evidence supporting the role of other risk factors. The only management strategy currently explored in the literature is abstinence, which appears to lead to significant improvement in autonomic investigations. Conclusion Current literature includes studies of highly heterogeneous populations, consuming differing volumes of alcohol over variable periods of time and utilising a number of different autonomic test batteries and criteria to diagnose autonomic dysfunction. Therefore, further research using homogeneous methods for measuring autonomic dysfunction in the field is needed. Despite this limitation, our review demonstrated that autonomic dysfunction is very common among alcohol abusers.
ISSN:0959-9851
1619-1560
DOI:10.1007/s10286-019-00618-8