Which substance is noted to increase water retention and worsen congestive heart failure symptoms?

• A. Salt
• B. Grapefruit
• C. Alcohol
• D. Vitamin C

Answer: (C)

Water retention in congestive heart failure comes from the heart’s reduced pumping combined with neurohormonal changes that promote sodium and water retention, leading to edema and worsening symptoms like breathlessness. Alcohol can worsen these problems through several pathways. Chronic alcohol use can cause alcoholic cardiomyopathy, weakening the heart muscle and raising venous pressures that push fluid into tissues. It can also lead to liver disease with low albumin levels, which lowers oncotic pressure and allows fluid to leak into interstitial spaces, increasing edema. Additionally, alcohol may interfere with the effectiveness of heart failure medications such as diuretics, making it harder to manage fluid status. Though salt intake directly drives fluid retention, alcohol’s impact on heart muscle and liver function can markedly worsen water retention and congestive symptoms.