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Alcohol & The Heart: The Effects of Alcohol on the Heart & Cardiovascular System

For people 21 years of age and older, alcohol is legal and is generally considered an acceptable substance when used responsibly in moderation.

The relationship between alcohol and the body’s cardiovascular health is complex and sometimes even contradictory. Some studies have associated low to moderate consumption with protection against heart disease, with detrimental effects at higher intakes.1 Other studies claim alcohol is bad for your heart and that the harmful effects of alcohol, even at low amounts, outweigh its potential benefits.2

Information from various studies has uncovered many connections between alcohol use, drinking patterns, and alcohol use disorders (AUDs) and cardiovascular disease, including high blood pressure (also known as hypertension), coronary artery disease, cardiomyopathy, stroke, atrial fibrillation, and peripheral arterial disease.3,4

What Alcohol Does to Your Heart & Cardiovascular System

Alcohol impacts everyone differently. Not only are there negative effects on someone’s appearance from alcohol, but also heavy drinking can cause serious problems internally like dangerous long-term effects on the heart and cardiovascular system. Excessive alcohol use and binge drinking has been shown to have negative effects on cardiovascular health, including increasing the risk of hypertension, coronary heart disease, stroke, heart failure, and cardiomyopathy.3

Some of the potential effects of alcohol on the heart and cardiovascular system after long-term or even excessive one-time use can include:4,5

  • Changes in heart rate.
  • High blood pressure (hypertension).
  • An irregular heartbeat (e.g., atrial fibrillation and other arrhythmias).
  • Cardiomyopathy.

Alcohol and Heart Rate

One of the many ways how alcohol affects affects the heart is by changing a person’s heart rate. While consuming alcohol, it is typical for your heart rate and blood pressure to increase temporarily. In general, a person’s heart rate is raised higher as they continue to drink in the short term.4 This increase in heart rate is not necessarily harmful but is something to be aware of, especially with continued consumption of alcohol.

It is possible to experience sustained supraventricular tachycardia (SVT) from chronic alcohol use.6 Tachycardia is when the heart beats at a more rapid speed than normal, and SVT is tachycardia that starts in the upper chambers of the heart.6,7

In extreme cases, supraventricular tachycardia can lead to cardiac arrest.7 Over time, alcohol’s effects on your heart rate may lead to other damage to the cardiovascular system.7

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If you think you or your loved one might be struggling with addiction, take our free, 5-minute alcohol addiction self-assessment. The evaluation consists of 11 yes or no questions intended to be used as an informational tool to assess the probability and severity of alcohol use disorder. The test is free and confidential, and no personal information is needed to receive the result.


Alcohol & Blood Pressure

Alcohol affects blood pressure in different ways. Both decreases and increases in your blood pressure from alcohol consumption is normal and typically a temporary side effect. As with the temporary heart rate increase, changes in blood pressure aren’t necessarily harmful but are another side effect to be aware of with the consumption of alcohol. However, continued, chronic and excessive can have lasting effects and potentially lead to sustained high blood pressure from alcohol consumption.8

If you are currently taking medications for high blood pressure, the use of alcohol with these medications can prompt adverse negative reactions, including:9

  • Dizziness.
  • Fainting.
  • Drowsiness.
  • Heart problems, such as changes in the heart’s regular heartbeat.

Alcohol & Irregular Heartbeats

An irregularity in a heartbeat—too fast, too slow, or erratically—is called an arrhythmia.10,11 Moderate to heavy alcohol consumption over time can increase the likelihood of a person experiencing an irregular heartbeat.10 Arrhythmia can lead to both tachycardia, when the heart beats too fast, or atrial fibrillation (AFib or AF), when the heart’s chambers don’t pump in a synchronized way because of an abnormal electrical signal.12

An increased risk of AFib is associated with heavy and binge drinking.13 AFib is one of the most common arrhythmias and increases the risk of a variety of cardiovascular complications, including stroke.4,10


Alcohol & Heart Disease

One of the more concerning long-term effects of alcohol on the heart is the increased risk of heart disease. Heart disease covers many heart-related ailments, including many discussed in this article, and can include coronary artery disease, which impacts the flow of blood to the heart.14 Symptoms of heart disease may include heart attack, arrhythmia, and heart failure.14 Excessive alcohol use can put people at a higher risk for heart disease.14


Alcoholic Cardiomyopathy

Another potential negative effect of alcohol on the heart is cardiomyopathy. Cardiomyopathy references problems with your heart muscle that may make it more difficult for your heart to pump blood.15 Alcoholic cardiomyopathy can be caused by long-term alcohol consumption. Alcohol-induced cardiomyopathy can make your heart muscle expand larger than its normal size. This can weaken your heart and may cause an irregular heartbeat, heart failure, or cardiac arrest.16

Cardiomyopathy caused by alcohol may present with signs and symptoms associated with congestive heart failure, including:16

  • Shortness of breath.
  • Palpitations.
  • Fainting episodes.
  • Muscular atrophy.
  • Major vein bulging in the neck.
  • Anorexia.
  • Tachyarrhythmia (commonly AFib).

The main aspect of alcoholic cardiomyopathy treatment is full abstinence from alcohol.16 However, cardiomyopathy treatment could also include medicine, symptomatic management, and patient resources and counseling.16


Alcohol & Heart Attacks

In some more severe cases, alcohol can cause a heart attack or at least lead to one. Coronary artery disease (CAD) is the most common types of heart disease in the United States.14 CAD affects the flow of blood to the heart, and decreased blood flow may lead to a heart attack, also known as a myocardial infarction.14 Research has found that excessive alcohol use of any kind can increase the risk of having a myocardial infarction.17 


Are the Effects of Alcohol on the Cardiovascular System Reversible?

Chronic alcohol use may lead to many serious heart conditions. However, a decrease in consumption or quitting drinking alcohol altogether can generally help improve cardiovascular issues.

Some cardiovascular effects, such as high blood pressure and cholesterol, may be improved through medication and lifestyle changes, though keep in mind that many of these medications have negative reactions when mixed with alcohol, as mentioned above.


Moderate Drinking & Heart Health

So, what about the studies and data that show some level of cardiovascular protection with moderate drinking? These associations, for the most part, come from large studies where everybody is lumped together and put into groups by alcohol consumption or drinking patterns to compare differences between each groups’ cardiovascular health. There are limitations to these types of studies and, in general, researchers acknowledge that the beneficial associations tend to be overestimated.3,19

In their 2021 Dietary Guidance for Cardiovascular Health, the American Heart Association advises, “if you don’t already drink, don’t start; if you choose to drink alcohol, limit intake.” This is in line with the 2020-2025 Dietary Guidelines for Americans, which says that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.

There are other risks that contribute to the risk or development of cardiovascular disease, from a person’s genetics, sex, age, overall health, the food they consume, and even socioeconomic status. And there also other risks aside from cardiovascular disease associated with alcohol consumption. So, while there may be evidence that consumption of small amounts of alcohol may be safe and even beneficial for the cardiovascular system, there are risks that alcohol poses that may outweigh those benefits.2


Prevention & Care

If you are concerned about the effects of alcohol on the heart because of excessive drinking, there are some steps you can take to reduce your risk of serious damage. There are a variety of prevention and alcohol addiction treatment options that can suit different lifestyles and needs.

You may not be experiencing any heart-related problems now but continued heavy alcohol use can lead to serious complications, sometimes quickly. If you drink heavily, regular check-ups with your doctor may be important. You can likely improve your health by quitting drinking and adding exercise to your daily routine.

Most importantly, you don’t want to wait until a problem worsens. If you are concerned about your drinking, talk to your doctor, or consider seeking treatment. Some treatment options include behavioral counseling, medication, and treatment for mental health problems related to alcohol, such as depression and anxiety.

You can work with your doctor or healthcare provider to figure out what treatment best suits you and your situation. Detox from alcohol may be an important first step that you take as you begin your work toward recovery. Detox can also prepare you for further treatment, including inpatient or outpatient rehab. Rehab treatment can teach you healthy ways of coping with life stressors that don’t involve relying on alcohol or other substances. If you find it difficult to stop drinking, there are treatment options available for both inpatient and outpatient needs.21



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