Heart Disease and Alcohol: Is Drinking Safe?
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Can You Drink Alcohol With Heart Disease?

Can You Drink Alcohol With Heart Disease?
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Published on June 20, 2025
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Alcohol, even in small amounts, may be detrimental to heart health, especially for those with or at risk for heart disease. Though it’s often said that moderate drinking, such as a nightly glass of red wine, is good for your heart and long-term health, experts have come to doubt that alcohol has any such benefits. Alcohol can contribute to a number of heart issues and likely doesn’t offer any protective effects.

How Alcohol Affects Heart Disease

Risk factors for heart disease include high blood pressure, high cholesterol, overweight or obesity, and prediabetes or diabetes, all of which may be exacerbated by alcohol consumption.

Blood Pressure Elevation

Alcohol raises the level of a hormone called renin, which both narrows blood vessels and decreases urination, thereby increasing blood pressure.

 Alcohol can also raise sympathetic nervous system activity, your body’s fight-or-flight response, and increase cortisol production, further contributing to higher blood pressure, says Rosy Thachil, MD, a cardiologist with NYC Health + Hospitals in Elmhurst, New York.
Moderate alcohol consumption is associated with higher systolic blood pressure (the top number on a blood pressure reading that measures the force with which your blood pushes against your arteries). Those who drink about one standard drink per day tend to have a 1.25 millimeters of mercury (mmHg) higher systolic blood pressure reading than nondrinkers, and those who drink about three drinks per day tend to have a 5 mmHg higher systolic blood pressure reading than nondrinkers.

 That variance may seem small, but even minor reductions in blood pressure through lifestyle changes can make a meaningful difference in one’s risk for heart problems.

Irregular Heartbeats (Arrhythmias)

Alcohol is linked to heart rate abnormalities (arrhythmias), including atrial fibrillation.

 This association is particularly strong when it comes to excessive or binge drinking, which can cause “holiday heart syndrome,” a term for cardiac rhythm disruption following weekend, holiday, or occasional heavy drinking.

Alcohol consumption can also lead to reduced vagal tone. High vagal tone is necessary to maintain a healthy resting heart rate and heart rate variability, as well as to prevent high blood pressure.

Cardiomyopathy

Cardiomyopathy is a disease in which the heart muscle struggles to pump blood effectively, leading to symptoms like shortness of breath, irregular heartbeat, chest pain, fatigue, and fainting.

 Complications include heart failure and cardiac arrest.
A particular condition called alcoholic cardiomyopathy occurs as a result of chronic alcohol consumption.

 “[Long-term heavy alcohol consumption] is commonly defined as consuming 80 grams (g) of alcohol per day over a period of at least five years,” says Natalia Beridze, MD, a cardiologist with Manhattan Cardiology in New York City. That’s the daily equivalent of one liter of wine or eight beers, for example. Alcohol promotes inflammation in the heart and is toxic to cells in the heart muscle, which causes heart dysfunction when consumed in high quantities.

Weight Gain and Metabolic Effects

Alcohol also has negative metabolic effects, which creates additional heart health risks. Overweight and obesity, as well as prediabetes or diabetes, are risk factors for heart disease.

“Given alcohol’s carbohydrate content, its consumption is definitely linked to weight gain, increased risk of insulin resistance and diabetes, and elevated lipid profile [from] worsening liver function,” says Dr. Beridze. Weight gain can worsen diabetes management, which can, in turn, negatively impact heart health.

Does Moderate Drinking Have Cardioprotective Effects?

Unfortunately, moderate alcohol consumption doesn’t provide heart-health benefits.

“The long-held belief that any amount of alcohol benefits cardiovascular health is increasingly being challenged by scientific evidence,” says Justine Welsh, MD, the director of addiction services at Emory Healthcare in Atlanta. “Current data suggests that even moderate drinking may elevate the risk of heart problems.”

Moderate drinking is defined as two standard drinks or fewer per day for men or one standard drink or fewer per day for women.

 “Less alcohol intake is better for the heart,” says Beridze.
If you’re a healthy person who consumes alcohol in a social setting, alcohol intoxication can still affect the heart’s functioning without causing noticeable symptoms, says Beridze. What’s more, the effects of moderate alcohol consumption may differ among males and females. For example, women who self-report as moderate alcohol consumers have a 29 percent higher risk of heart disease than women who report a lower alcohol intake.

Even wine isn’t cardioprotective, says Beridze. “It’s about the absolute amount of total ethanol intake, and even small amounts of alcohol can be cardiotoxic for individual patients,” she says.

If you choose to consume alcohol, experts encourage you to stick to low or moderate levels of consumption and avoid binge drinking. If you don’t currently drink alcohol, there’s no reason to start, especially when it comes to your heart health.

Alcohol and Medications for Heart Disease

If you’re currently taking medications for heart disease, such as blood pressure medications, anticoagulants, or statins, talk to your prescriber or pharmacist about potential interactions. Alcohol may reduce the effectiveness of these medications or increase the risk of side effects, says Beridze.

“I recommend avoiding alcohol intake with medications, especially in moderate to large amounts,” she says. Some of the potential effects of combining cardiovascular medications with alcohol use include an elevated bleeding risk, higher blood alcohol levels, and problematically lower blood pressure.

Before You Drink

If you have or are at risk for heart disease, Beridze stands by the recommendation that the less alcohol you consume, the safer you are. Cardiovascular health risks increase as alcohol consumption increases, even with light alcohol consumption.

“For people with or at risk of heart conditions, particularly conditions like arrhythmia, heart failure, cardiomyopathy, liver disease, history of stroke, or hypertension, alcohol should be limited or avoided altogether,” says Dr. Thachil. “No alcohol may be the safest.”

Here are three steps to take when it comes to navigating alcohol consumption with heart disease.

  • Discuss your alcohol use with your cardiologist or healthcare provider to assess your risk as an individual, says Thachil. In your conversation, include the medications you take to address their potential interactions with alcohol.
  • Consider nonalcoholic alternatives like nonalcoholic beer, wine, or spirits, or mocktails, says Dr. Welsh.
  • If you tend to cope with stress by drinking alcohol, work on developing other ways to unwind, such as connecting with loved ones, spending time outside in nature, or seeking therapy for mental health support.

When to Seek Help

In 2023, nearly 29 million people in the United States had an alcohol use disorder, a medical condition characterized by the inability to control one’s alcohol consumption despite its negative consequences.

 “Having an alcohol use disorder isn’t defined by the amount someone drinks, but by the problems that come from that drinking,” says Welsh.

Welsh advises seeking help from your healthcare provider if you experience any of the following signs:

  • Difficulty limiting the amount of alcohol you consume
  • Experiencing cravings for alcohol
  • Neglecting responsibilities due to alcohol use
  • Continuing to drink despite its negative consequences
  • Needing to consume more alcohol for the same effect or experiencing withdrawal when not drinking

Help is available in various forms, including detoxification support, medications to manage withdrawal and reduce cravings, individual or group counseling, and support groups like Alcoholics Anonymous and SMART Recovery. “These resources are often tailored to a person’s goals, whether it be reducing use or stopping completely,” says Welsh.

To find care, the Substance Abuse and Mental Health Services Administration (SAMHSA) also has a help line to help connect you with treatment.

The Takeaway

  • Despite the long-held belief that alcohol can be beneficial for heart health, even small amounts of alcohol appear to be harmful for certain individuals, especially those with or at risk for heart disease.
  • Alcohol consumption is associated with higher blood pressure, heartbeat irregularities, cardiomyopathy, and metabolic dysfunction, all of which are detrimental to overall heart health.
  • If you have or are at risk for heart disease, experts recommend minimizing your alcohol consumption.
  • If you struggle to limit the amount of alcohol you consume, help and support is available, ranging from medications to counseling.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  2. Understand Your Risk for Heart Disease. National Heart, Lung, and Blood Institute. March 24, 2022.
  3. Can Drinking Raise My Blood Pressure? Harvard Health Publishing. October 1, 2024.
  4. What Is a Standard Drink? National Institute on Alcohol Abuse and Alcoholism. December 2024.
  5. Di Federico S et al. Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies. Hypertension. October 2023.
  6. Jain A et al. Holiday Heart Syndrome. StatPearls. January 16, 2024.
  7. The Vagus Nerve: A Key Player in Your Health and Well-Being. Massachusetts General Hospital. October 16, 2024.
  8. Brunner S et al. Impact of acute ethanol intake on cardiac autonomic regulation. Scientific Reports. June 24, 2021.
  9. Cardiomyopathy. Mayo Clinic. February 21, 2024.
  10. Alcoholic Cardiomyopathy. StatPearls. August 8, 2023.
  11. Diabetes and Alcohol. MedlinePlus. May 12, 2023.
  12. About Moderate Alcohol Use. Centers for Disease Control and Prevention. January 14, 2025.
  13. Alcohol Raises Heart Disease Risk, Particularly Among Women. American College of Cardiology. March 28, 2024.
  14. Alcohol-Medication Interactions: Potentially Dangerous Mixes. National Institute on Alcohol Abuse and Alcoholism. May 8, 2025.
  15. Biddinger KJ et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Network Open. March 25, 2022.
  16. Why You Shouldn’t Rely on Alcohol During Times of Stress. Cleveland Clinic. April 16, 2020.
  17. Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics. National Institute on Alcohol Abuse and Alcoholism.
  18. Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. January 2025.
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Chung Yoon, MD

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Chung Yoon, MD, is a noninvasive cardiologist with a passion for diagnosis, prevention, intervention, and treatment of a wide range of heart and cardiovascular disorders. He enjoys clinical decision-making and providing patient care in both hospital and outpatient settings. He excels at analytical and decision-making skills and building connection and trust with patients and their families.
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