Alcohol and Your Heart

03/29/2021 | 5 min. read

Dr. Stephen Sinatra

Dr. Stephen Sinatra

Everybody knows excess alcohol is hard on the liver and that drinking too much adversely affects your brain, as evidenced by impairments in balance, reaction time, judgment, and memory. But what about alcohol and heart health? Isn’t alcohol good for your heart? 

An occasional drink is not harmful to most people—but “not harmful” is a far cry from beneficial. Let’s look at the origins of this myth and the reality of how alcohol affects your heart.

The Myth of the French Paradox

Back in the early 1990s, French researchers published an article in The Lancet examining France’s unexpectedly low cardiovascular death rate, in light of the population’s high intake of saturated fat. They proposed that this paradox was attributed in part to their high consumption of wine.  

The press latched on to this provocative story, and the narrative morphed into the message that drinking wine and other types of alcohol are a boon for heart health. Some people actually started drinking for their health!

It’s true that modest consumption of alcohol slightly increases HDL cholesterol, relaxes the arteries, and reduces platelet aggregation and the formation of blood clots. It is also true that resveratrol, a potent polyphenol in red wine, has multiple health benefits. However, you would have to drink bottles and bottles of red wine to get the amount of resveratrol in a single supplement.

The French paradox led to additional research that pointed to other protective factors, such as the abundance of olive oil, fiber, fruits, and vegetables in the typical French diet. Plus, saturated fat is no longer positioned as a primary cause of heart disease. 

Yet, the myth persists, and alcohol is more popular than ever. According to the latest government statistics, 54.9% of Americans age 18 and over have had alcohol in the past month. Nearly 26% reported binge drinking (4+ drinks within two hours for women and 5+ for men), and 6.3% admitted to heavy drinking (binge drinking five or more days in the previous month). 

How Much Is Too Much? 

I know you can find studies showing that “moderate” alcohol use—up to one drink a day for women and two for men—improves heart health. Yet, the latest research suggests this level of alcohol consumption is linked with an increased risk of accidents, falls, several types of cancer, and numerous cardiovascular problems. In fact, studies show that as little as one drink a day can increase your risk of heart disease and death.

That is why I believe the current guidelines for alcohol intake are too high. My recommendation for both men and women is to limit alcohol to no more than three or four drinks a week—and if you have been diagnosed with certain cardiovascular disorders, it’s best to avoid alcohol altogether. 

Does Alcohol Affect Cholesterol Levels? 

You may have heard that alcohol increases HDL cholesterol, which is one reason why it’s supposed to be good for your heart. The reality is that this effect is modest and can be better achieved by other means such as exercise. As for other lipids, moderate alcohol intake has little effect, but heavy drinking raises both LDL cholesterol and triglycerides.

What Is the Relationship Between Drinking Alcohol & High Blood Pressure? 

Just one episode of heavy drinking can raise your blood pressure temporarily—and heavy drinking or frequent bouts of binge drinking can lead to a diagnosis of hypertension. If you have hypertension, moderation is essential. 

Is There an Association Between Alcohol & Irregular Heartbeat? 

Definitely. There is a condition called holiday heart syndrome, which refers to arrhythmias and other heart problems that come on after heavy drinking. Emergency rooms see clusters of this during the holidays when binge drinking is more common. Even light drinking can provoke episodes of atrial fibrillation, and patients with this type of cardiac arrhythmia are better off avoiding alcohol. 

What About Alcohol, an Enlarged Heart & Congestive Heart Failure? 

Alcoholic cardiomyopathy is a fairly common consequence of years of alcohol abuse. The toxic effects of heavy drinking damage the heart muscle and impair its ability to pump blood. Over time, the heart becomes dilated (enlarged) and ever weaker, which may eventually lead to congestive heart failure and premature death. 

Can Alcohol Cause a Heart Attack? 

Drinking is associated with numerous risk factors that increase your likelihood of having a heart attack, including arterial damage, hypertension, serious arrhythmias, and heart failure. It doesn’t take all that much alcohol to increase your risk. A large study published in The Lancet found an increased risk of heart attack and death with just six drinks a week.

Is It Safe to Drink Alcohol When You Are Taking Heart Medications?

Alcohol has adverse interactions with many medications, including several drugs prescribed for cardiovascular disorders. 

  • Nitroglycerin: Taking nitroglycerin while drinking can stimulate a rapid heartbeat, dizziness, and changes in blood pressure. 
  • Coumadin (warfarin): Even occasional or moderate alcohol consumption while on Coumadin increases your risk of internal bleeding. 
  • Antihypertensives: Alcohol can trigger dizziness, drowsiness, and arrhythmias in individuals who are taking any of several classes of blood pressure drugs.
  • Statins: Alcohol intensifies the adverse effects of statins on the liver. 

You also need to be aware that mixing alcohol with some drugs used to treat non-cardiac conditions may result in cardiovascular side effects. For example, combining alcohol with stimulant drugs like Ritalin and Adderall, which are prescribed for ADHD—and even with ibuprofen and other over-the-counter NSAIDs—can cause heart problems.

Read labels carefully, ask your doctor and pharmacist about potential interactions, and take them seriously. And remember that adverse effects can occur even when alcohol and medications are taken at different times. 

When it comes to alcohol just keep in mind ... that less is more!!

 

 

 

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

More About Dr. Stephen Sinatra