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Alcohol and Your Heart

Studies have shown a link between light to moderate drinking and a lowered risk for heart attack and heart and blood vessel diseases. Also stroke, type 2 diabetes, and gallstones.

Alcohol may have some health benefits. But it may lead to abusive drinking and other diseases. Because there's no sure way to know who will have an abuse problem, the American Heart Association (AHA) and other experts don't advise drinking alcohol for possible health benefits. Talk with your healthcare provider about the benefits and risks of light to moderate alcohol use.

Learn the meaning of moderation

Moderate drinking is defined as no more than 1 drink a day for women and 2 drinks a day for men. A drink is considered 12 ounces of regular beer, 4 to 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Pregnant people should not drink alcohol because it can lead to birth defects.

Moderation is different for everyone. This is because alcohol’s effects depend on how the body absorbs and breaks down alcohol. Older adults break down alcohol more slowly than younger people. This means alcohol stays in their bodies longer. A person's height and weight also impact how alcohol is absorbed. Alcohol is absorbed faster if you're smaller and lighter. People from some ethnic groups also have a harder time breaking down alcohol. Even small amounts can have a big effect on their bodies.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.

Know how you react to alcohol

People respond differently to alcohol for other reasons besides height and weight. This includes sex, age, genetics, and overall health. The amount of alcohol you drink, when you drink it, and any history of problem drinking can also affect your reaction to alcohol.

When alcohol is taken into the body, it passes from the stomach and small intestine into the blood. Then it's carried to all organs of the body. Alcohol can be dissolved in water, so it enters your organs in based on the amount of water they hold. Less alcohol remains in your bloodstream if there's more water available in the organs to soak up alcohol.

Your liver does most of the work of breaking down alcohol. The liver removes alcohol from your body so it won't damage other organs. But the liver can only break down a certain amount of alcohol per hour. A very small amount of alcohol escapes this process and is passed unchanged in your breath, sweat, and urine. Until all the alcohol in the body has been broken down, it stays in the brain and other tissues of the body and continues to cause effects.

Different ways alcohol is broken down

In general, women and older men have less water in their organs than younger men. This means less alcohol enters their organs and more alcohol stays in their bloodstream. Younger women make less of the stomach enzyme that breaks down alcohol in the stomach. This means more alcohol is available to be soaked up into the blood. So they will have a higher blood alcohol level than a man of the same age who drinks the same amount of alcohol.

Heredity may play a role in how alcohol and your body act together. Moderate drinkers who have genes that cause a slower breakdown of alcohol are at much lower risk for heart and blood vessel disease than moderate drinkers who have genes that cause rapid breakdown of alcohol.

Alcohol is broken down more slowly when it's soaked up. The process of soaking up alcohol is slowed when you drink alcohol during or right after a meal. The slower soaking up process lets the liver break down alcohol at a rate that keeps more of it from reaching other organs.

Because the liver breaks down alcohol, people with liver disease are more sensitive to drinking. Some medicines may cause harmful reactions if you drink while taking them. Alcohol affects the breakdown of many medicines by increasing the activity of some and decreasing the activity of others. For example, heavy alcohol consumption when taking acetaminophen can lead to liver damage. 

The danger of drinking is much higher than the possible heart and blood vessel benefits for people with a history of alcoholism.

Health benefits and concerns

The AHA says the best-known positive health effect of alcohol is a small increase in HDL, or good cholesterol. But regular physical activity is a more effective way to raise HDL ("good") cholesterol and reduce plaque buildup in your arteries. Alcohol also has a mild blood thinning effect. This keeps platelets from clumping together to form blood clots.

Excessive drinking can raise triglyceride levels. It also increases blood pressure and raises the risk for heart attack and stroke. It can also raise the risk for abnormal heart rhythms such as atrial fibrillation.

Consider the calories in alcohol

Alcohol contains no fat, but it has 7 calories per gram. That's between 100 and 150 calories for the alcohol in a typical beer, wine, or spirits drink. Add to that the calories in drink mixers, and drinking could lead to weight gain.

Medical Reviewers:

  • Callie Tayrien RN MSN
  • Stacey Wojcik MBA BSN RN
  • Steven Kang MD