How Alcohol Affects Your Heart, Blood Pressure, and More

Michelle Routhenstein, MS, RD, CDE


March 15, 2024

Whether you would describe yourself as a social drinker or someone who enjoys a 6 PM glass of wine like clockwork, alcohol is deeply engrained into our society. Surveys show that over 50% of Americans say they’ve consumed alcohol in the past month, and over 25% of those aged 18 and older say they have engaged in binge drinking in that same time frame.

Despite how casual alcohol consumption has become, it’s important to recognize its potential negative effects on health — particularly when it comes to our hearts. In this article, we’re examining the link between alcohol use, blood pressure, and other cardiovascular risk factors so you can make informed decisions.

Alcohol: Effects on Heart Health

Many of us are familiar with how alcohol can affect our decision-making skills and inhibition in social settings, but there’s much more happening that may not be as obvious. Read on if you’re asking, how does alcohol affect the heart? 

Note: We’re going to be mentioning “excessive alcohol intake” throughout this article, which the CDC defines as:

  • Women: 4+ drinks on one occasion or 8+ in a week
  • Men: 5+ drinks on one occasion or 15+ in a week 

Keep this in mind as we discuss the ways that these types of drinking habits affect your heart health.

Increased blood pressure

A common question I receive is: Does alcohol lower blood pressure or raise it? The answer is the latter. 

Excessive alcohol intake can stimulate your sympathetic nervous system, which is involved in activating your body’s “fight-or-flight” response (part of which is increased blood pressure). Research shows that even 12 grams of alcohol consumption per day can increase systolic blood pressure by 1.25 mmHg (a standard drink in the US is 14 grams).

Drinking in this way can lead to increased heart rate and constricted blood vessels, elevating blood pressure. Over time this can also disrupt the balance of hormones involved in blood pressure regulation and promote weight gain. 


Excessive alcohol intake over time can lead to cardiomyopathy, a condition of a weakened heart muscle and impaired pumping function. This is because the toxicity of alcohol damages and weakens the heart muscle over time, making it harder to pump blood efficiently. 

Alcohol-induced cardiomyopathy can result from the toxic effects of ethanol on heart cells, leading to structural damage and dysfunction. Alcohol can also encourage nutritional deficiencies like thiamine, which are essential for proper heart function. 


Arrhythmias are irregular heartbeats. Excessive alcohol intake can disrupt the electrical signals that regulate heart rhythm, leading to abnormalities such as atrial fibrillation or ventricular arrhythmias. Drinking can also lead to changes in your electrolytes and fluid balance, which may increase the risk of developing arrhythmias.


Excessive alcohol intake can promote high triglycerides and LDL cholesterol, which can lead to the formation of plaque in the arteries (atherosclerosis). Excessive alcohol intake is also pro-inflammatory and can trigger oxidative stress in your blood vessels, impairing endothelial function and damaging artery health.

Increased triglyceride levels

Alcohol can increase the production of triglycerides in your liver. It can also impair your body’s ability to break down and clear triglycerides from your blood. Plus, many people who drink alcohol regularly experience weight gain around the abdomen, which is associated with elevated triglycerides.

Weakened immunity

Alcohol can disrupt the function of immune cells, impairing their ability to recognize and combat harmful germs. It can also promote inflammation and oxidative stress, further suppressing your immune function. Additionally, alcohol can disrupt the balance of bacteria in your gut, compromising gut barrier integrity and increasing your susceptibility to infections.

Weight gain and related chronic disease risk

Alcohol often contains more calories per serving than we realize. It also has the potential to increase appetite and possibly overeating, leading to unintentional weight gain. Being overweight or obese comes with the risk of related conditions like type 2 diabetes and heart disease. Alcohol metabolism can also interfere with how well your body can burn fat, promoting fat storage. 

Interactions with certain medications

It’s important to be aware of how alcohol may interact with the medications you’re using, either by increasing or decreasing their effects on your body. For example, alcohol can interact with benzodiazepines (Xanax, Ativan, Valium) or opioids (Morphine, Oxycodone, Tramadol), increasing their sedative effects. It can also interfere with the metabolism of blood-thinning medications like Warfarin or beta blockers, reducing their effectiveness or increasing your risk of adverse effects like a severe drop in blood pressure.

Increased risk of stroke

Alcohol can increase your risk of having a stroke by raising blood pressure and promoting the formation of blood clots. The risk of Afib and atherosclerosis with excessive drinking can also increase your risk of stroke.

Alcohol-induced cardiotoxicity

This refers to the harmful effects of excessive alcohol on your heart muscle. We already talked about how excessive alcohol intake can promote cardiomyopathy, or a weakened heart, as well as arrhythmias, all of which can increase your risk of cardiovascular events. 

Alcohol Consumption Guidelines for Heart Health

If you don’t consume alcohol currently, there’s no reason to start now. The potential adverse effects, particularly on heart health, far outweigh the potential benefits. If you do drink alcohol, it’s important to adhere to the recommended guidelines to minimize negative alcohol effects on heart health.

Moderate alcohol consumption is defined as up to one drink per day for women and up to two drinks per day for men. Guidelines typically refer to standard drinks containing approximately 14 grams of pure alcohol. For example, a 12-ounce beer, a 5-ounce glass of wine, or 1.5 ounces of distilled spirits.

Note that even one drink can increase your blood pressure. In other words, you don’t have to drink a ton of it to experience the effects and it’s important to be aware of how alcohol impacts you in this way.

The various types of alcohol may have different effects on heart health. While red wine contains resveratrol, an antioxidant with potential heart health benefits, it can also be high in sugar and calories. Beer contains a variety of B vitamins, but it’s also high in carbohydrates. Spirits, like whiskey or gin, typically have more alcohol and fewer calories compared to wine and beer but often contain added sugars, syrups, or high-calorie mixers. 

Strategies for Managing Alcohol Consumption and Heart Health

Having an occasional drink is unlikely to affect your long-term heart health. It’s more important to be aware of your overall alcohol consumption, make responsible choices, and engage in everyday lifestyle habits that are good for your heart, like: 

  • Adopting a nutrient-dense diet pattern that leans on fruits, vegetables, whole grains, lean proteins, nuts, and seeds — and ditching ultra-processed foods high in saturated fat, sodium, and added sugars — is the best way to ensure your body receives optimal nutrition. 
  • Engaging in a regular exercise routine that includes both cardio and resistance training.
  • Do your best to practice stress management techniques that promote a sense of calmness and clarity.
  • Get regular wellness exams, even if you don’t have obvious or concerning symptoms.
  • Understanding your heart health risks and monitoring your blood pressure levels. 

If you feel pressured to drink in social situations, there are a growing number of nonalcoholic beverages you might choose instead. For instance, mocktails can be made with ingredients like fruit juices, sparkling water, herbs, and flavored syrups (just be aware that these can also contribute added sugar and calories). You could also opt for a non-alcoholic beer. Overall, quantity is key. 

Holiday Heart Syndrome is also something to be aware of in terms of how social gatherings can encourage excessive alcohol use and trigger irregular heart rhythm. This condition usually affects people without existing heart disease. While temporary, it’s thought to be due to the toxic effects of alcohol on your heart’s electrical system, leading to things like shortness of breath, chest discomfort, and dizziness. This is just another reason to be intentional about your alcohol use. 

Drinking Responsibly for Your Heart

Alcohol is commonplace today, but it’s not an innocuous substance. Excessive alcohol use can damage your heart health over time. It can raise blood pressure, impair blood vessel health, weaken your heart muscle, and encourage the buildup of fats in your blood — increasing your risk of heart attack and stroke. Make responsible choices when (and if) consuming alcohol and be sure to practice heart-healthy habits every day. 

Looking for more answers to how alcohol affects the heart or seeking ways to improve your heart health? Consider my Heart Health Optimization group coaching program or explore 1:1 counseling with me for more tailored guidance. 


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