Q: I have a long history of symptoms of dehydration. Is it true that plaque can develop to protect blood vessels that are in need of hydration?

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• Edward O’Dell January 5, 2017

  Where in the study you reference does data indicate drinking more water lowers the risk of heart disease? The higher glucose levels in the study group could just as likely been the cause of the coronary disease.

• Ben Brown, MD January 12, 2017

  Hello Mr. Odell,

  In your response you asked,

  Where in the study you reference does data indicate drinking more water lowers the risk of heart disease? The higher glucose levels in the study group could just as likely been the cause of the coronary disease.

  You have a good point, causation and correlation are not always linked. Though suggestive, it is not always conclusive. I welcome your comment and discussion.

  Pardon other readers as I will get a little technical here. Given the association with the increased serum sodium despite the increased glucose (note below: in a non-dehydrated individual increased glucose would have been expected to have lowered the serum sodium levels) it is suggestive that there is a component of this correlation that is related to dehydration, not simply glucose.

  (“In marked hyperglycemia, ECF osmolality rises and exceeds that of ICF, since glucose penetrates cell membranes slowly in the absence of insulin, resulting in movement of water out of cells into the ECF. Serum Na concentration falls in proportion to the dilution of the ECF, declining 1.6 mEq/ L for every 100 mg/dL (5.55 mmol/L) increment in the plasma glucose level above normal. This condition has been called translational hyponatremia because no net change in total body water (TBW) has occurred. No specific therapy is indicated, because Na concentration will return to normal once the plasma glucose concentration is lowered.”

  As with many issues, causation is much more difficult to establish and correlation can be more easily establish.

  One of the methods I used to answer this difficult question was to look not just at the one study, but to look at the pathophysiology and the biochemical likelihood of the other factors being causative.

  Dehydration, perhaps along with increased glucose is likely worse than just dehydration or increased glucose alone.

  Given the common risk factors for both increased glucose and for heart disease, dehydration in this population is likely to be an additional risk and very unlikely to be health promoting.

  I hope that is helpful and would also appreciate hearing any further thoughts.

  To your health,

  Ben

• Krish January 6, 2017

  Does drinking other liquids like tea count as part drinking water? thanks.

• Ben Brown, MD January 12, 2017

  great question! Some liquids are more hydrating then others, but most are hydrating (even coffee and tea). This was a myth that has some basis in reality as caffeine is dehydrating, but the liquid more than makes up for it if you are consuming moderate quantities. Even foods, watery fruits and other beverages are hydrating. The main liquid that is dehydrating is alcohol as it requires water to metabolize it. Here are a few articles that talk about the hydrating power of other liquids.

  To your health, Ben

  http://www.huffingtonpost.com/2013/06/27/dehydration-myths_n_3498380.html

  http://www.webmd.com/parenting/features/healthy-beverages#1

• Sandy January 6, 2017

  I notice that my heart seems to “flutter” when I don’t drink enough liquid, so the correlation between getting enough fluid and heart health had already crossed my mind. Does coffee/tea count in the
  daily suggested amount?

• Ben Brown, MD January 12, 2017

  Please see the answer to the other question as it is related. Heart flutter for some is also related to caffeine intake, so great that you notice and pay attention to your body and its needs! To your health, Ben

• Erica January 8, 2017

  Unfortunately, your article is 10 years too late for me. What benefit does drinking water have for people with heart disease?

• Ben Brown, MD January 12, 2017

  Yes, that is not discussed in this article. The main benefits I have seen have been decreased angina or chest pain. All of the same physiologic benefits to hydration apply (decreased blood viscosity, etc). As with many things, Better late then never. To your health, Ben

• Mary S January 12, 2017

  For at home, I keep a 12 oz glass in the bathroom and fill it and drink it down during most of my trips in there ( I am on several meds that cause a dry mouth so all of that chugging acts as a comfort measure). For going out I have several 700 ml flip-top bottles that I fill up and take along; if I’m going to be gone a long time or during hot weather sometimes I will freeze one overnight and then take it, too. Bottoms up!

• Ben Brown, MD January 12, 2017

  Thanks for sharing your tips! It is both knowing what to do and how to do it. To your health, Ben