Alcohol and your heart

Many of us enjoy a drink or two once in a while. It does not cause any harm, and can be rather relaxing after a long days work.

But alcohol bears the power of taking over your life – it can become an addiction to a point where it starts to exert its bad effects on different vital systems of the body. And the heart is one of them.

But how does alcohol effect the heart? Let’s take a look at this a bit further.

Effects of alcohol on the heart

bigstock-Glass-of-Red-Wine-Abstract-Hea-12575768Alcohol can affect the heart in a variety of ways, but most importantly it can increase the chances of developing different risk factors that lead to heart disease. Consuming alcohol in moderation is generally okay, but once it crosses a limit, it can start to have damaging effects. It is not possible to state in any way as to who may develop these harmful effects from alcohol, so the general recommendation from the American Heart Association is the not start drinking alcohol if you have never touched a drop before.

Some of the cardiovascular effects of drinking large amounts of alcohol include –

  • Diabetes mellitus
  • High blood pressure
  • High blood triglyceride level (a type of fat in the blood similar to cholesterol)
  • Weakening of the heart muscle called cardiomyopathy
  • Weight gain and obesity
  • Irregular heart rhythms such as atrial fibrillation
  • Sudden cardiac death


It is evident that the long term effects are many, and with continuing high consumption of alcohol, death is inevitable at a young age.

But I hear alcohol in small amounts is good for the heart!

Yes, what you have heard is correct. But let us take a closer look at the facts about this.

The studies that have been conducted regarding the beneficial effects of alcohol on  the heart are based on red wine. The interest in red wine being good for you in moderation has sprung from the fact that French people, who are keen red wine drinkers, are rarely affected by heart disease despite eating foods that are high in fat content. While this association is true, it is more likely to be due to the healthy lifestyle they follow otherwise.

How is red wine beneficial?

Red wine is said to be high in compounds called flavinoids and anti-oxidants. These compounds help fight damaging free radicals that are produced within the body that would normally damage blood vessels and other tissues. By neutralising these, alcohol is believed to have a protective effect on the heart.

In addition to this, red wine is also believed to increase the levels of ‘good’ HDL cholesterol in the blood. HDL cholesterol carries harmful cholesterol from the blood to the liver for it to be removed from the body, and thus prevents atherosclerosis and heart disease. Red wine is also rich in a compound called Resveratrol. Resveratrol stimulates the cells that line the inner surface of blood vessels (called endothelial cells) to produce a compound called nitric oxide. Nitric oxide prevents platelets (blood cells) from clumping together and forming clots, and also helps keep blood vessels open and patent. It prevents the development of atherosclerosis as well, thus preventing the development of heart attacks.

More recent evidence has shown that alcoholic beverages such as beer and cider also contain these compounds, and may be beneficial to individuals if consumed in moderation.

So all the above sounds good, doesn’t it? The problem with this is that these benefits are not concretely proven through clinical trials, and any evidence of its benefits are still in early stages of research. These same benefits can be obtained through exercise and dieting, so this is recommended instead. Furthermore, it is unclear as to how much red wine is required to produce any benefits in the first place, so patients may consume a lot more than is actually needed and develop harmful effects instead. We recommend that you do not consume alcohol in any form if you have been teetotal for all these years, or keep it in moderation if you already are.

I don’t drink everyday, but I like to go out once in a while and have a few!

Consuming a large amount of alcohol for the purpose of getting drunk and having a good time is called ‘binge drinking’. While it may appear that binge drinking is better than regular drinking as you are not drinking everyday, it is in fact rather harmful! Binge drinking can put tremendous amount of stress on the heart, and can result in patients developing an irregular heart rhythm called atrial fibrillation. Interestingly, patients tend to develop this when they are on holiday with friends or family, as drinking during that time often exceeds what one would normally have at home. Alcohol binging causing atrial fibrillation is called ‘Holiday heart syndrome’.

Patients who develop atrial fibrillation can feel tremendously unwell, with symptoms including nausea, thumping in the chest, light headedness and breathlessness. This condition requires immediate treatment, and often requires hospitalisation.

So should I start drinking alcohol in moderation to protect my heart?

The answer to that question is no. While there may be benefits to drinking a small amount of alcohol a day, there are still risk associated with it. If you have never consumed alcohol before, DO NOT start now. If you are already drink alcohol, make sure it is in moderation. If you drink excessively, it is time to cut down!

What is ‘drinking alcohol in moderation’?

You may be wondering what this means. In the western world, alcohol limits that can be harmful have been clearly defined, but this is not so clear in South Asia (India). From studies that have been conducted, there are no applicable limits that Indians should specifically follow when it comes to alcohol. In order to make it a bit clearer, it is recommended that the World Health Organisation guidelines be followed. This includes –

[box title=”Recommended Alcohol Intake for Indians” color=”#04a9ec”]

[list style=”star”]

  • Women should not drink more than 2 drinks per day
  • Men should not have more than 3 drinks a day
  • Do not exceed more than 4 drinks on one occasion
  • Avoid drinking if you are driving or if you are pregnant



As is seen above, the amount remains rather vague. How does one define ‘one drink’? In the United Kingdom, a clear system has been devised that defines the limits that one should consume if they wish to drink alcohol in moderation. These limits are called ‘units’. One unit is equal to 10ml or 8 grams of pure alcohol (remember all available alcoholic drinks are different percentages).

Their recommendations include –

  • Men should not drink more than 3-4 units a day
  • Women should not consume more than 2-3 units a day
  • Following a heavy drink session, avoid alcohol for at least 48 hours


Below is a list of commonly consumed drinks and how many units each one of them constitutes –

Image courtesy BBC (

From the above image, it is clear that the permissible quantity that amount to moderation is between 2 to 4 units. For example, two shots of a small whisky is the daily limit.

Bear in mind that the above limits are designed for the western population. It may well be applicable to Indians as well, but the amounts that can be consumed will be a lot smaller.

How do I cut down my alcohol intake?

This is the difficult step, and requires hard work and determination. If you are drinking alcohol in moderation it is not difficult to stop. Cut down on your intake gradually, and eventually you will be able to stop.

The problem arises if you are a heavy drinker, as alcohol tends to be addictive. We offer advice to patients who feel they have a problem with alcohol, and can help them stop drinking over time.


Alcohol in high quantities can be damaging to the heart. Staying away from alcohol is the best way to protect it from this damage. However, if you are already consuming alcohol and wish to continue to do so, then following the above guidance can help.

Tools and Resources


1. Interesting in finding out how much alcohol you consume? Use this tool below to take a look!

Alcohol unit calculator

Go to NHS Choices homepage

Dr Vivek Baliga
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