What is the relationship between alcohol consumption and cardiovascular disease (CVD)?

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Last updated: March 18, 2025 • View editorial policy

From the Guidelines

For adults who consume alcohol, limiting intake to no more than 1 drink per day for women and 2 drinks per day for men is recommended to reduce the risk of cardiovascular disease. This recommendation is based on the most recent guidelines from the American Heart Association, as outlined in the 2023 AHA/ACC/ACCPC/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease 1. The relationship between alcohol consumption and cardiovascular disease (CVD) is complex, with moderate alcohol intake associated with reduced cardiovascular events in many populations, but high intake linked to serious adverse health and social consequences, including hypertriglyceridemia, hypertension, liver damage, and increased risk of breast cancer 2.

Key Considerations

  • Non-drinkers should not start drinking for potential cardiovascular benefits, as the risks associated with alcohol consumption outweigh any potential benefits 1.
  • For those with existing cardiovascular conditions, consultation with a healthcare provider about alcohol use is essential to minimize potential interactions with cardiovascular medications and reduce the risk of adverse effects.
  • Alcohol in moderation may increase HDL ("good") cholesterol and reduce blood clotting factors, potentially lowering heart attack risk, but excessive consumption can lead to hypertension, cardiomyopathy, arrhythmias, and stroke.
  • People taking cardiovascular medications should be particularly cautious, as alcohol can interact with many heart medications, including anticoagulants, antihypertensives, and statins, potentially reducing their effectiveness or increasing side effects.

Recommendations

  • Limit alcohol intake to no more than 1 drink per day for women and 2 drinks per day for men.
  • Do not advise patients with cardiovascular disease to consume alcohol for the purpose of cardiovascular protection 1.
  • Routinely ask and counsel patients about substance use to reduce ASCVD events 1.

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 protective and harmful effects.

  • Moderate alcohol intake has been associated with a reduced risk of CVD, primarily due to its effect on increasing high-density lipoprotein cholesterol (HDL-C) levels 3, 4, 5.
  • The protective effect of moderate alcohol intake is thought to be due to its ability to raise HDL-C levels, as well as its antithrombotic effects 5.
  • However, heavy drinking has been shown to increase the risk of CVD, and the benefits of moderate drinking may be offset by the risks of heavy drinking 3, 6, 7.

Drinking Patterns and CVD Risk

  • The pattern of drinking is also important, with moderate daily drinking appearing to be more beneficial than binge drinking 4, 6.
  • Drinking with meals may also provide additional protection against CVD, possibly due to the protective effects of alcohol on postprandial endothelial function 4.
  • The type of alcoholic beverage consumed may also play a role, with some evidence suggesting that red wine may be more cardioprotective than other beverages 5, 6.

Recommendations for Alcohol Intake

  • 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 3.
  • Physicians should screen for excessive alcohol use and advise individuals to limit their alcohol intake to moderate amounts, preferably consumed with meals 6.
  • The question of whether alcohol intake should be encouraged as a measure to prevent CVD remains unanswered, and individuals should discuss their alcohol intake with their primary care provider 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.