Actor Nelsan Ellis, who played the inimitable Lafayette Reynolds on HBO’s True Blood, died of heart failure on Saturday at only 39 years old. The actor’s heart failure was reportedly due to alcohol withdrawal after years of struggling with a substance abuse disorder, Ellis’ manager, Emily Gerson Saines, told The Hollywood Reporter.
“Nelsan’s father has bravely agreed for me to share the circumstances of Nelsan’s heart failure. Nelsan has suffered with drug and alcohol abuse for years. After many stints in rehab, Nelsan attempted to withdraw from alcohol on his own,” Saines told The Hollywood Reporter. “According to his father, during his withdrawal from alcohol he had a blood infection, his kidneys shut down, his liver was swollen, his blood pressure plummeted, and his dear sweet heart raced out of control.” After four days in the hospital, Ellis was pronounced dead on July 8.
“Nelsan was ashamed of his addiction and thus was reluctant to talk about it during his life,” Saines said. “His family, however, believes that in death he would want his life to serve as a cautionary tale in an attempt to help others.”
It’s normally very unusual for someone in their 30s to die from heart failure, but as Ellis’ sad case shows, there can be exceptions to this rule.
Heart failure happens when a person’s heart is so weak it can’t effectively pump blood to the rest of the body. Symptoms of heart failure vary from person to person but can include shortness of breath while going about daily activities, having trouble breathing when lying down, weight gain accompanied by swelling in the feet, legs, ankles, or stomach, and feeling tired or weak overall, according to the Centers for Disease Control and Prevention.
People often confuse heart failure with heart attacks and cardiac arrest. While they can be related, they’re different conditions, Christopher B. Granger, M.D., director of the Cardiac Intensive Care Unit at Duke Health and a professor of medicine at Duke University, tells SELF. Heart attacks, which occur when there’s an interruption of blood flow to the heart, can weaken the muscle to the point where a person develops heart failure, Dr. Granger says. Cardiac arrest, on the other hand, happens when the heart suddenly stops beating effectively. It often happens due to an arrhythmia, or irregular heartbeat, and heart failure is a common contributing factor.
“The usual cause of heart failure is the development of heart disease over years and years of exposure to risk factors like high blood pressure and diabetes,” Dr. Granger says. That’s why people are most likely to develop heart failure in their 60s and 70s—and with people living longer and rates of high blood pressure and diabetes rise, heart failure rates are on pace to increase 45 percent by 2030.
However, if a young person has engaged in long-term excessive alcohol use, it can weaken their heart to the point where they develop heart failure. “It’s unfortunate, but this is one of the things we see in somebody who’s young and otherwise healthy,” Nicole Weinberg, M.D., cardiologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. Moderate drinking is defined as up to one drink a day for women and up to two drinks a day for men. Over time, drinking beyond these limits can weaken the heart, liver, kidneys, and other parts of the body enough that a person experiences multi-system organ failure, Dr. Weinberg says.
While quitting alcohol and drugs can seem like a good thing, if someone has a substance abuse disorder, doing it without medical supervision can be dangerous. After years of use, a person’s body is accustomed to functioning with these substances in its system. Suddenly detoxing can put huge stress on a person’s body, Dr. Granger says, especially if their organs have already been damaged due to a prolonged substance abuse disorder.
“What happens is a person’s neurologic system gets hyperactive [after sudden withdrawal], and that’s accompanied by an outpouring of adrenaline from the adrenal glands,” Dr. Granger says. “The combination of adrenaline and underlying damage to the heart can be very dangerous.”
Quitting alcohol suddenly can result in symptoms like anxiety, depression, shakiness, headache, nausea, and vomiting, according to the U.S. National Library of Medicine. Sometimes, the withdrawal symptoms are severe enough to be categorized as delirium tremens, the U.S. Library of Medicine says, which “involves sudden and severe mental or nervous system changes” due to the lack of alcohol. Delirium tremens symptoms can involve hallucinations, fatigue, seizures, and heavy sweating. It can also cause irregular heartbeat and rapid heart rate, which can lead to heart failure in some people if their heart is very damaged.
In order to detox safely, medical experts will often put a person with a substance abuse disorder on medicine to blunt the withdrawal’s effects on their body, Dr. Granger says.
There are certain lifestyle changes beyond cutting back on alcohol that can lower your risk of developing heart failure.
“The best thing people can do to prevent heart failure is to follow a lifestyle that results in good heart health,” Dr. Granger says. Beyond excessive drinking and drug use, smoking, consistently eating unhealthy food, and not exercising enough can all increase a person’s risk of developing coronary heart disease (the most common kind of heart disease, which happens when plaque builds up in the heart’s arteries), high blood pressure, and diabetes. These three conditions can all raise a person’s risk of heart failure.
To improve cardiovascular health, the American Heart Association recommends getting at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of both). That may sound like a lot, but it really comes down to 30 minutes a day, five times a week.
Loading your diet with healthy whole foods can also boost your heart health, as can cutting back on unhealthy fats, sodium, and added sugar. These can all contribute to excess weight gain over time, boosting your risk of developing issues like obesity, diabetes, and heart disease that can eventually lead to heart failure.
If you’re concerned about your heart health or worried about your risk of developing heart problems down the line, speak with your doctor. They can walk you through any potential risk factors you may have and how to address them, along with performing tests like an EKG to see how your heart is functioning if you’re really concerned, Dr. Weinberg says. And, again, if you’re specifically worried about how alcohol may be affecting your health, it’s always best to talk to your doctor for guidance.
If you or someone you know is concerned about substance abuse, help is out there. You can call the Substance Abuse and Mental Health Services Administration’s (SAMHSA) hotline at 1-800-662-HELP. You can find more information and resources on the SAMHSA website.
Watch: “I Have a Pre-Existing Condition”: Real People Share Their Health Conditions in Response to the AHCA
[after sudden withdrawal]