Heart Disease and Alcohol: What You Need to Know

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According to the CDC, heart disease is the leading cause of death in the United States—about one person dies from it every 36 seconds. 

In this article, we’ll go into more detail about how alcohol affects this vital organ, and some of the sobering conditions that can result. 

Does Alcohol Benefit Your Heart?

There’s a popular claim that alcohol—particularly red wine—can benefit your heart. Over 180 studies have suggested that moderate alcohol consumption can increase levels of “good” cholesterol in the body (HDL) and reduce the risk of heart disease. (Moderate drinking is defined as two or fewer drinks a day for men and one or fewer for women.) These studies apply to beer, spirits, and wine. Wine also contains antioxidants like resveratrol known to boost heart health.

alcohol and heart disease
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However, these studies have limitations. None of them are long-term studies. And although they demonstrate a correlation between moderate drinking and heart health benefits, they don’t prove causation. It’s still unclear whether a drink or two a day causes improved heart health. For instance, it’s possible that people who choose to drink in moderation are more likely to make other healthy choices, like exercising and eating a nutritious diet.

And the potential benefits of alcohol certainly don’t outweigh the confirmed risks. A 2016 study in The Lancet found that alcohol was a factor in 10% of global deaths among people aged 15-49. The researchers concluded, “The safest level of drinking is none.”

Doctors and organizations like The American Heart Association do not recommend drinking alcohol to gain potential health benefits. We can gain the same benefits (without the risks) by eating healthy foods and exercising. Grapes, blueberries, and some fruit juices have the same antioxidants found in wine.

How Does Alcohol Affect the Heart?

While moderate drinking may offer minor benefits for the heart, heavy drinking carries major risks. 

Have you ever noticed that drinking alcohol makes your heart race? That’s because heavy drinking puts extra stress on the heart. Alcohol increases activity in the sympathetic nervous system and the amount of blood pumping through the heart. It also stimulates the release of stress chemicals like cortisol and adrenaline. 

At the same time, alcohol can decrease arterial dilation. For these reasons, your heart must put in extra work to do its job effectively. This can cause the heart’s electrical system to short circuit, leading to serious issues.

Let’s examine some of the most common impacts of alcohol on heart health.


Cardiomyopathy is a disorder that impacts the heart muscle. It impairs the heart’s ability to pump blood and sometimes results in irregular heartbeats. Causes include viral infections of the heart, coronary artery disease, high blood pressure, and alcohol abuse.

Three forms of cardiomyopathy generally affect adults. Hypertrophic cardiomyopathy, a rare and usually inherited form, happens when the left ventricle muscle thickens. Restrictive cardiomyopathy, the least common form in the U.S., is the result of a stiff heart muscle that can’t properly fill with blood. 

And the most common form, dilated cardiomyopathy, occurs when the heart’s cavity stretches and enlarges. It is often caused by chronic alcohol abuse and nutritional deficiencies related to alcohol use disorder. Most people with dilated cardiomyopathy eventually develop heart failure.

High Blood Pressure

High blood pressure, or hypertension, can damage the heart and lead to serious health problems if it persists over time. Hypertension is defined as blood pressure at or above 130/80 mmHg. Blood pressure at or above 140/90 mmHg is classified as Stage 2 hypertension. 

high blood pressure, heart attack
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Hypertension increases the risk of heart disease and stroke, the two leading causes of death in the United States. In 2019, it was linked to the deaths of 516,955 U.S. individuals. 

In heavy drinkers, increases in high blood pressure average about 5 to 10 mmHg. Researchers have identified several reasons for the relationship between alcohol and hypertension. These include alcohol’s impact on the central nervous system and sympathetic nervous system. 

Alcohol can impair the baroreceptors, which communicate information about blood pressure to the brain, allowing it to maintain proper blood pressure. Alcohol also expands extracellular fluid, which has been shown to increase blood pressure in rats. Additionally, alcohol-induced increases in cortisol can increase blood pressure. Recommendations for reducing hypertension include limiting alcohol intake to one drink per day.

Read More: Alcohol and High Blood Pressure

Coronary Heart Disease

Coronary heart disease (CHD), also known as coronary artery disease, is the leading cause of death in the United States. It occurs when the arteries can’t deliver enough oxygen-rich blood to the heart, often leading to chest pain, heart attack, or sudden cardiac arrest. 

Research on CHD and alcohol is mixed, but several studies show that alcoholics and problem drinkers have an increased risk of coronary heart disease. As mentioned above, alcohol contributes to high blood pressure, which is a significant risk factor for developing CHD. 


Pericarditis is the inflammation of the pericardium, a structure that surrounds the heart to help it work properly and hold it in place. When inflamed, the pericardium can rub against the heart and cause discomfort and chest pain. Eventually, serious cases of pericarditis can lead to abnormal heart rhythms and death.

Alcohol is linked to chronic inflammation throughout the body. Heavy drinking promotes inflammation by increasing the production of harmful endotoxins and bacteria in the gut. It also weakens the intestinal barrier, which allows the bacteria and endotoxins to travel from the gut to the bloodstream, thus spreading to the organs. Inflammation can damage the organs and lead to disease.  

Treating pericarditis involves decreasing inflammation, and experts advise eating a balanced diet, managing stress, and drinking less alcohol. 

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Alcohol and Heart Attack Risk

Consumption of alcohol, especially binge drinking, is linked with higher risk of heart attack. According to a Harvard study, people who binge drink are 72% more likely to have a heart attack than people who don’t. 

blood pressure
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Risk factors for heart attack include high blood pressure, stress, and obesity, all of which can be caused or worsened by heavy alcohol consumption. Alcohol itself increases the risk of heart attack because it can produce irregular heartbeats, cause cardiomyopathy, and contribute to high triglycerides. High triglycerides are linked to high blood cholesterol, another risk factor for heart attack.

When these risk factors are combined, the possibility of a heart attack significantly increases.

Alcohol and Stroke

Stroke is one of the leading causes of death in the United States. Ischemic strokes occur when blood flow is blocked through the artery that supplies blood to the brain. Hemorrhagic strokes are the result of an artery in the brain rupturing or leaking blood, putting too much pressure on brain cells. 

Risk factors for stroke include heart disease, high blood pressure, high blood cholesterol, and obesity. Again, consumption of alcohol can cause or worsen all of these factors. On its own, excessive alcohol use is another risk factor for stroke.

Research shows that even one drink a day can increase stroke risk by 10-15 percent. Four drinks daily increases risk by 35 percent. Binge drinking is also a known factor contributing to stroke. 

Frequently Asked Questions About Alcohol and Heart Health

Can you drink alcohol with heart disease?

In most cases, people with heart disease can continue drinking in moderation. Still, every individual is different and some medications for heart disease don’t mix well with alcohol, so it’s best to consult with your doctor. 

heart disease
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Can you drink alcohol with a pacemaker?

Although you can drink alcohol with a pacemaker, moderation is strongly encouraged. Doctors typically recommend not drinking for at least 24 hours after implantation. Again, it’s best to consult with a doctor about drinking with a pacemaker, especially if you have underlying issues.

How soon can you drink alcohol after a heart attack?

After a heart attack, it’s best to allow a recovery period before drinking alcohol. There’s no set time frame, but some doctors recommend waiting a month. After that, moderate drinking is acceptable in most cases.

Alcohol and Heart Disease: The Takeaway

In moderation, alcohol has no impact or a slight positive impact on heart health. Heavy drinking, however, is linked to numerous health issues. It contributes to high blood pressure and can cause abnormal heart rhythms and damage to the heart muscle. Heavy alcohol consumption also increases the risk of stroke, heart attack, coronary heart disease, and heart failure. 

Online treatment for alcohol use can help. Ria Health offers support for drinking in moderation or quitting alcohol use altogether. You can access support groups, recovery coaching, anti-craving medication, and tracking tools through an app on your smartphone. With Ria Health, you can take control of your relationship with alcohol and your heart health.

Learn more about how Ria Health works, or sign up for a free call to find out more about our program.

Written By:
Ashley Cullins
Freelance writer with contributions to numerous addiction blogs and a passion for relatable content.
Reviewed By:
Bruce Hodges
New York-based writer, editor, and fundraising consultant with over three decades of experience.
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