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How alcohol affects your heart, from moderate to excessive drinking

How alcohol affects your heart, from moderate to excessive drinking

Insider

By Kelly Burch

March 10, 2020

Alcohol’s impact on your heart is largely dependent on how much you drink. The American Heart Association recommends no more than one drink per day for women, and two drinks per day for men. 

“If you get above that, you start to lose your benefit and exchange it for harm,” says Lauren Gilstrap, MD, a cardiologist at Dartmouth-Hitchcock Medical Center. 

How moderate alcohol consumption affects the heart 

Light to moderate drinking may have some protective benefits for your heart, according to a 2017 study published in the Journal of the American College of Cardiology

The study found that men who drank less than 14 drinks per week were 21% less likely to die from cardiovascular disease, and women who drank less than seven drinks per week had a 34% reduced risk of cardiovascular mortality. 

“The key is moderation,” Gilstrap says. “It’s never recommended that a patient start drinking for cardiovascular benefits, but someone who has a glass of wine with dinner can continue to enjoy that.” 

However, when you drink, your heart rate increases, as does your blood pressure. A 2019 study found that even moderate drinking — at seven to 13 drinks per week — increased rates of high blood pressure. Compared to people who never drink, moderate drinkers were 53% more likely to have stage 1 hypertension, a major risk factor for heart disease

Moreover, additional research has casted doubt on whether alcohol has any heart benefits. A 2018 study published in The Lancet analyzed data from 195 countries and concluded that “the safest level of drinking is none.” That study called for reconsideration of guidelines that say moderate drinking is safe. 

Excessive alcohol consumption harms your heart

Most of the negative effects of alcohol on your heart come with heavy drinking or binge drinking, which is defined by the National Institutes of Health as more than four standard drinks per day, or five drinks in one setting. 

Heavy drinking can raise blood pressure and heart rate. One 2018 study found that women who drink heavily are three times more likely to have hypertension, while binge drinkers of both sexes are 70% more likely to have high blood pressure. 

In addition, the more you drink, the higher your heart rate will get. This increased heart rate may contribute to atrial fibrillation (AFib), an irregular heartbeat that increases risk for stroke and heart failure. Alcohol consumption is linked with increased risk for AFib, even at moderate levels. Heavy drinking can also lead to a condition called Holiday Heart Syndrome, where people experience AFib without having any history of the condition. 

Finally, heavy drinkers are also 1.5 times more likely than non-drinkers to experience a stroke, according to a 2017 review by the National Institutes of Health

The benefits of red wine might be overstated

The idea that red wine is good for heart health gets a lot of press, but the full story is more complicated than that, Gilstrap says. The American Heart Association, for example, says that drinking more red wine will generally not lead to a healthier heart. 

However, red wine has antioxidant properties and flavonoids, molecules that can benefit heart health, in moderation. A 2017 study in The American Journal of Clinical Nutrition found that moderate drinking had a positive impact on cholesterol, and that wine in particular increased levels of good cholesterol, which is an indicator of a healthy heart. 

There are healthier ways to get the benefits of antioxidants and flavonoids, which are rich in almonds, berries, apples, citrus, spinach, and black and green tea (or dark chocolate, if you’re craving a treat). 

All of the research with different conclusions can be confusing. Yet there are some clear takeaways: heavy drinking can hurt your heart health, while a standard drink (of any variety) over dinner is likely fine for most people. Of course, it’s best to talk to your doctor about your particular situation before indulging.