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The Impact of Alcohol & Heart Health

When it comes to maintaining a healthy heart, alcohol use is not recommended.[1]  Even moderate alcohol use can have detrimental effects. Excessive alcohol use can be devastating to heart health, increasing the risk of conditions like high blood pressure, cardiomyopathy, arrhythmias, and damage to the heart muscle.[2]

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How Much Alcohol Is Too Much?

While occasional and moderate social drinking may be enjoyed responsibly without significant risks to heart health, it is important to understand the definition of true moderation when it comes to alcohol intake.

Generally, it is advised that women drink no more than one drink per day and men drink no more than two drinks per day.[3]

The Centers for Disease Control and Prevention explains that a standard drink contains 0.6 ounces of pure alcohol. Examples of one drink include the following:[3]

  • 12 ounces of beer with 5% alcohol
  • 8 ounces of malt liquor with 7% alcohol
  • 5 ounces of wine with 12% alcohol
  • 1.5 ounces of distilled spirits with 40% alcohol

People with certain health conditions like cirrhosis should not drink at all. Anyone who has ever struggled with substance misuse or substance use disorder (SUD) is advised to avoid alcohol use entirely.

Drinking outside the bounds of these guidelines can lead to various health problems, including an increased risk of heart-related issues. Whether drinking more drinks than recommended daily or binge drinking large amounts of alcohol once or twice a week,  risks to the heart may manifest as higher blood pressure, increased arrhythmias, and increased risk of heart disease.[2]

If you find yourself consistently exceeding moderate drinking guidelines, experiencing adverse effects from alcohol, or finding it hard to control your alcohol consumption, this could be indicative of an alcohol abuse problem. With comprehensive alcohol addiction treatment, you can safely stop drinking and build a positive life in recovery.

How Does Alcohol Damage Heart Health? 

Excessive alcohol consumption can have detrimental effects on heart health, presenting several potential risks.[2] We’ll explain all of these risks in a moment, but this table can help you understand the long-term and short-term cardiovascular risks drinking can cause.

Short-Term RisksLong-Term Risks
Increased blood clottingHigh blood pressure
Irregular heartbeatCardiomyopathy
 High cholesterol
 Weight gain
 Weakened immune system

High Blood Pressure

Alcohol has multiple mechanisms that can contribute to the development or exacerbation of high blood pressure, including these:[4]  

  • Stimulation of the sympathetic nervous system
  • Disruption of hormonal balance
  • Dehydration
  • Weight gain and obesity
  • Interference with medications
  • Increase in insulin resistance

While moderate alcohol consumption may have minimal impact on blood pressure for some, heavy drinking significantly raises the risk of hypertension. 


Excessive and prolonged drinking directly damages the heart muscle, weakening its ability to pump blood effectively.[5] Additionally, alcohol can lead to nutritional deficiencies, which further contribute to cardiomyopathy. Alcohol also produces harmful byproducts that cause oxidative stress and damage the heart cells while disrupting the regulation of calcium in the heart, which leads to abnormal heart muscle function.[5] 

Irregular Heart Rhythm 

Alcohol can cause irregular heart rhythms in the following ways:[6]

  • Disrupting the heart’s electrical signals
  • Causing imbalances in electrolytes
  • Stimulating the sympathetic nervous system
  • Damaging the heart muscle
  • Interacting with medications

Even moderate alcohol consumption can sometimes trigger irregular heartbeats. 

Increased Triglyceride Levels

Alcohol can raise triglyceride levels in several ways. First, excessive alcohol intake adds extra calories and contributes to weight gain, leading to an increase in triglycerides. Next, alcohol disrupts how the liver processes and removes triglycerides as well as interferes with metabolism processes.[7] When alcohol use disrupts diet choices, causing a nutritional imbalance, triglyceride levels may rise.

Caloric Intake & Weight Gain

Alcohol is a high-calorie beverage that contributes to overall caloric consumption and weight gain over time.[8] Drinking may stimulate appetite, which decreases the ability to eat in moderation. Poor nutritional choices often accompany alcohol use, leading to an unbalanced diet, impaired metabolism, and interrupted sleep patterns that all cause further weight gain.

Increased Risk of Blood Clotting

Alcohol use in any amount can increase the risk of blood clotting for these reasons:[9] 

  • Promotes the clumping of blood platelets
  • Disrupts the normal clotting process
  • Raises triglyceride levels
  • Causes dehydration
  • Impairs liver function
  • Interferes with blood-thinning medications 

Weakened Immune System

Alcohol inhibits immune cell activity and reduces the immune response, which together increases susceptibility to infections and impairs wound healing.[10] For those who already have a weakened immune system or are at risk of infection, it is advisable to avoid alcohol use entirely. Even for those with strong immune systems, binge drinking or alcohol use, in general, may increase the likelihood of developing an illness or infection if exposed to a virus or bacteria.

Symptoms of Alcohol-Related Heart Disease

The American Heart Association says some people have alcohol-related heart disease and no symptoms. In a study of 2,525 adults, those in treatment for alcoholism had 10.3% more evidence of heart injury and 69.2% higher markers for inflammation when compared to others. They did not have symptoms.[15]

The Centers for Disease Control and Prevention says people with heart disease may experience symptoms like the following:[16]

  • Chest pain
  • Upper back or neck pain
  • Indigestion
  • Heartburn
  • Nausea
  • Fatigue
  • Dizziness
  • Shortness of breath
  • Fluttering feelings in the chest
  • Swelling in the feet, ankles, legs, abdomen, or neck

Alcohol Consumption: Factors to Consider

Several factors can impact how much alcohol is too much when it comes to heart health. These include the following:[2,11-14] 


Older adults may be more vulnerable to the harmful effects of alcohol due to metabolic changes, diminished tolerance levels, or use of medications that may amplify the effects of alcohol or be rendered ineffective.

Medical Conditions

Alcohol intake of any amount can aggravate current liver disease, heart disease, diabetes, and immune disorders. Alcohol abuse and AUD can potentially contribute to the development of these problems in otherwise healthy individuals.


Certain medications can interact negatively with alcohol, leading to adverse side effects or reduced efficacy.


Genetic factors may impact how alcohol is processed by the body, increasing some individuals’ risks of alcohol-related health complications.

Researchers say the gene ALDH2 is central to the metabolism of alcohol. People with one copy of the ALDH2 gene don’t metabolize alcohol properly and can experience cardiac issues (such as a fast heartbeat) when they drink. This gene may be protective against alcoholism, as people feel sick when they consume instead of calm and relaxed.[19]

Genes aren’t destiny. You could have all the right or wrong genes and still develop alcoholism.

Family History

A family history of AUD, or SUD in general, can increase the risk for alcohol-related health issues.


Lifestyle factors, such as diet, exercise, and overall health habits, can have an effect on how alcohol impacts the body. Those who are sedentary may be at higher risk of complications due to alcohol use.


Alcohol can have different impacts on males and females due to body composition differences and metabolism differences. Women are generally more prone to the harmful effects of alcohol consumption.

How to Reduce Your Alcohol Intake

You’ve examined the question of how alcohol affects the heart, and you’ve decided to make a change. Here’s what you need to know.

While some people can quit or cut back without help, it’s not a safe approach for everyone. If you experience withdrawal symptoms (like anxiety, irritability, hallucinations, or shaking) between drinks or when you try to cut back, you need medical supervision to get sober safely.[17] Talk to your doctor about how to get started.

If it’s safe for you to do so, these tips from the National Health Service may help you to cut down how much you drink:[18]

  1. Determine how much and how often you’ll drink.
  2. Set a budget for your alcohol intake.
  3. Tell your friends and family you’re cutting down and will need their support.
  4. On your drinking days, consume smaller sizes (like a bottle of beer instead of a pint).
  5. Choose drinks with a lower alcohol content.
  6. Cut back a little each day.

Download apps like Reframe or AlcoDroid Alcohol Tracker on your phone to help you measure how much you drink and why it’s smart to quit.

If you find it’s hard to cut back without sliding back into your old drinking habits, consider connecting with Alcoholics Anonymous. You could find out more about how treatment works, and you could get motivated to enroll and change your life for the better.

Updated May 7, 2024
  1. Alcohol and health: all, none, or somewhere in-between? The Lancet Rheumatology. 2023;5(4):e167.
  2. Alcohol’s effects on the cardiovascular system. Piano MR. Alcohol Research: Current Reviews. 2017;38(2):219-241.
  3. Alcohol use and your health. Centers for Disease Control and Prevention. Published December 29, 2021. Accessed December 18, 2023.
  4. Alcohol intake and blood pressure levels: A dose-response meta-analysis of nonexperimental cohort studies. Silvia Di Federico, Filippini T, Whelton PK, et al. Hypertension. Published July 31, 2023. Accessed December 18, 2023.
  5. Alcoholic cardiomyopathy. Shaaban A, Gangwani MK, Pendela VS, Vindhyal MR. PubMed. Published 2021.
  6. Holiday heart syndrome revisited after 34 years. Tonelo D, Providência R, Gonçalves L. Arquivos Brasileiros de Cardiologia. 2013;101(2).
  7. Alcohol and plasma triglycerides. Klop B, Rego AT do, Cabezas MC. Current Opinion in Lipidology. 2013;24(4):321-326.
  8. Alcohol: Balancing risks and benefits. Chan TH. The Nutrition Source. Published May 22, 2019. Accessed December 18, 2023.
  9. Influence of alcohol consumption on blood coagulation in rotational thromboelastometry (ROTEM): An in-vivo study. Eismann H, Sieg L, Ahmed H, et al. Korean Journal of Anesthesiology. 2020;73(4):334-341.
  10. Alcohol and the immune system. Sarkar D, Jung MK, Wang HJ. Alcohol Research: Current Reviews. 2015;37(2):153-155.
  11. Drinking over the lifespan. Barry KL, Blow FC. Alcohol Research: Current Reviews. 2016;38(1):115-120.
  12. Associations between medical conditions and alcohol consumption levels in an adult primary care population. Sterling SA, Palzes VA, Lu Y, et al. JAMA Network Open. 2020;3(5):e204687-e204687.
  13. The genetic relationship between alcohol consumption and aspects of problem drinking in an ascertained sample. Johnson EC, St. Pierre CL, Meyers JL, et al. Alcoholism: Clinical and Experimental Research. Published May 21, 2019.
  14. Alcohol may be more risky to the heart than previously thought. European Society of Cardiology. Published May 24, 2022. Accessed December 18, 2023.
  15. Heavy drinking may cause heart damage before symptoms appear. American Heart Association. Published December 18, 2019. Accessed May 1, 2024.
  16. About heart disease. Centers for Disease Control and Prevention. Published May 15, 2023. Accessed May 1, 2024.
  17. Alcohol withdrawal. U.S. National Library of Medicine. Published February 28, 2023. Accessed May 1, 2024.
  18. Tips on cutting down. National Health Service. Published September 2022. Accessed May 1, 2024.
  19. Genetics and alcoholism. Edenberg H, Foroud T. Nature Reviews Gastroenterology and Hepatology. 2013;10(8):487-494.
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