From the Guidelines
For adults with cardiovascular disease, limiting alcohol intake to no more than 1 standard drink daily for women and no more than 2 standard drinks daily for men is recommended, as supported by the most recent guidelines from 2023 1. The relationship between alcohol consumption and cardiovascular disease (CVD) is complex, with moderate alcohol intake associated with reduced cardiovascular events in many populations, as noted in earlier studies 1. However, the benefits of moderate alcohol consumption must be weighed against potential risks, including hypertriglyceridemia, hypertension, liver damage, and increased risk of breast cancer. Key considerations include:
- A standard drink contains about 14 grams of pure alcohol, equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.
- People with certain cardiovascular conditions, such as cardiomyopathy, arrhythmias, or hypertension that is difficult to control, should consider avoiding alcohol completely.
- Those taking medications like anticoagulants, certain antihypertensives, or statins should consult their healthcare provider about potential interactions with alcohol. The most recent guidelines from 2023 1 emphasize that patients with chronic coronary disease should not be advised to consume alcohol for cardiovascular protection, highlighting the importance of other lifestyle modifications like regular exercise and a heart-healthy diet.
From the Research
Relationship Between Alcohol Consumption and Cardiovascular Disease
The relationship between alcohol consumption and cardiovascular disease (CVD) is complex, with evidence suggesting both beneficial and harmful effects depending on the amount and pattern of consumption.
- Studies have consistently shown a J-shaped inverse association between alcohol consumption and CVD morbidity and mortality, with light to moderate alcohol intake associated with a lower risk of CVD compared to abstainers or heavy drinkers 2, 3, 4, 5.
- The mechanisms underlying the cardioprotective effects of moderate alcohol consumption are thought to include increases in high-density lipoprotein cholesterol (HDL-C) levels, as well as improvements in hemostatic markers, insulin sensitivity, and endothelial function 2, 3, 5.
- However, heavy or binge drinking has been shown to have the opposite effect, increasing the risk of CVD and other cardiovascular endpoints such as hypertension, diabetes, and congestive heart failure 4, 5.
- The type of alcoholic beverage consumed may also play a role, with some evidence suggesting that red wine may be more cardioprotective due to its antioxidant content, although this is not universally accepted 3, 4.
- The American Heart Association recommends limiting alcohol intake to no more than 2 drinks per day for men and 1 drink per day for women, although some studies suggest that the optimal level of consumption for cardiovascular health may be lower, particularly for women 2, 5.
- Overall, while moderate alcohol consumption may have some cardiovascular benefits, the risks and benefits must be carefully weighed, and individuals should consult with their primary care provider before making any changes to their alcohol consumption habits 2, 3, 5, 6.