Heart Disease and Alcohol: Is Drinking Safe?

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.

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 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.

“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.