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Alcohol and the Heart

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Many of us love to have a drink from time to time. Most of us consume alcohol in moderation, but some unfortunately cross the recommended limit. In the long term this can be detrimental to health.


Alcohol is well known to have a number of negative effects on vital organ functioning. Amongst these vital organs, the heart is probably the most important one. In this article, we shall take a look at the effect of alcohol on the heart muscle, reviewing both the good and bad effects.

What Is Considered Too Much Alcohol?

There is no specified limit published in literature that clearly defines what is high alcohol intake in the Indian population. However, it is widely regarded that drinking more than 1 – 2 small drinks a day is high consumption. This can include 2 small beers, 1 large whiskey, 1 large brandy etc.

How Does Alcohol Affect The Heart?

There are 2 aspects to the effect of alcohol on the heart. One aspect is the benefits of drinking alcohol in moderation, which has positive effects on the heart muscle. The other aspect is the negative effects that it can have on the heart when alcohol is consumed in heavy quantities. We shall take a look at the negative effects first.

Dangerous Effects Of Alcohol On The Heart

As we have mentioned above, consuming large quantities of alcohol on a regular basis can have a significant impact on the way the heart functions. Below are some of the negative effects that alcohol can have on the heart.

1. Irregular heart beating

Binge drinking large amounts of alcohol can sometimes push the heart to start beating in an irregular fashion. This irregular beating is often atrial fibrillation. Individuals who are on holiday who binge drink can sometimes develop this condition – for this reason it is sometimes called ‘holiday heart’ syndrome.

Abstinence from alcohol and medical therapy is required to treat this condition. Patients may need to be admitted to hospital for monitoring and administration of medicines.

2. Weakening of the heart muscle (‘alcoholic cardiomyopathy’)

Scientific and clinical research has clearly demonstrated that heavy drinking on a regular basis and over a long period of time can make the heart weak. The heart can become bigger than normal, and does not contract as efficiently as before.

This condition is called alcoholic cardiomyopathy, which is a type of dilated cardiomyopathy.

In a nutshell, high alcohol intake can cause heart failure.

Patients with alcoholic cardiomyopathy must abstain from alcohol completely. They will require medication that can strengthen the heart muscle and help it regain its normal function. However, some people may not regain this normal function despite treatment.

3. High alcohol intake can increase the blood pressure

It is well recognised that high blood pressure is a risk factor for the development of heart disease and stroke. Alcohol can increase the blood pressure, thus increasing the chance of developing a heart attack in the future.

In fact, just having 1 session of binge drinking can temporarily increase the blood pressure. If this is continued over a period of time, then it can lead to a more sustained rise in blood pressure i.e. hypertension.

Research has shown that just cutting down from heavy drinking to moderate drinking can reduce the blood pressure by around 3 to 4 mmHg. When cutting down alcohol however, it must be done gradually, as a sudden reduction can cause a paradoxical rise in the BP.

Finally, alcohol can also cause weight gain, which is a risk factor in the development of high blood pressure.

Protective Effects Of Moderate Alcohol Consumption

Can consuming alcohol regularly protect the heart?

Clinical studies have shown that drinking 1 or 2 drinks per day can markedly reduce the chances of developing heart disease. This reduction is by around 30 to 50%! One reason for this is the reduction in the development of atherosclerosis.

But how exactly does alcohol in moderation help reduce risk and protect the heart?

In a paper published in the American Heart Association journal Circulation, the cardioprotective effects of alcohol on the heart were mediated through the increase in the levels of HDL cholesterol in the blood (i.e. the good cholesterol levels increase).

We have discussed HDL cholesterol elsewhere, but to recap, HDL cholesterol transports cholesterol from the blood all the way back to the liver. This can reduce the development of atherosclerosis.

While alcohol can increase HDL levels, it appears that the rise is only small. The concurrent use of medication along with plenty of cardiovascular exercise can elevate the levels further. This can be more effective in preventing heart disease.

Other mechanisms include a reduction in the level of clotting of the blood within the arteries. This is due to the effect of alcohol on platelet function and how the clotting factors function.

Alcoholic drinks such as red wine contain certain components (flavonoids, resveratrol etc) that possess antioxidant properties. These have a protective effect on the cells lining the blood vessels (endothelial cells). This protection can prevent atherosclerosis.

Our Recommendation

As such, the evidence supporting regular consumption of alcoholic beverages has not been confirmed in the Indian population. While drinking alcohol in moderation may help reduce heart disease, it can over the long run cause obesity and high blood pressure, especially if the limit is crossed.

At HeartSense, we recommend avoiding alcohol completely and instead follow a healthy diet and regular exercise (as these have been proven to work).


1. Pearson, Thomas A. “Alcohol and heart disease.” Circulation 94.11 (1996): 3023-3025. Read here.

Read More

1. Binge Drinking



Dr Vivek Baliga B
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