Top Things to Know: Alcohol Use and Cardiovascular Disease
Published: June 09, 2025
Prepared by Mariann R. Piano, RN, PhD, FAHA, Statement Chair and Gregory M. Marcus, MD, FAHA, Statement Vice Chair
- Alcohol consumption remains extremely common, with 85% of U.S. adults reporting alcohol use at some point in their lives.
- The evidence regarding the cardiovascular effects of light to moderate alcohol consumption (1-2 drinks/day) is mixed, with some observational studies suggesting potential benefits for certain outcomes like coronary artery disease, while Mendelian randomization studies have not found a clear protective effect.
- Heavy alcohol consumption (generally >2 drinks/day) and binge drinking are consistently associated with worse cardiovascular outcomes, including hypertension, coronary artery disease, stroke, arrhythmias, cardiomyopathy, and heart failure.
- The consumption of 2 or more drinks per day can result in an increase in blood pressure, while reduction in heavy drinking (≥6 drinks/day) can lead to a decrease in blood pressure.
- Randomized control trial data have demonstrated a heightened risk of atrial fibrillation among those who consume heavy amounts of alcohol (such as 10 or more drinks per week), but the evidence is less clear regarding the relationship with other cardiac arrhythmias.
- Long-term excessive alcohol use is associated with the development of alcoholic cardiomyopathy, a form of dilated cardiomyopathy, but the exact amount and duration of alcohol consumption required is unknown.
- The relationship between alcohol consumption and heart failure risk is complex, with some studies suggesting a potential protective effect of light to moderate intake, while higher levels (>21 drinks/week) are associated with increased risk.
- Certain populations, such as women, older adults, and those with diabetes, may be differentially impacted by the cardiovascular effects of alcohol consumption.
- Significant knowledge gaps remain, and more research, particularly from well-designed randomized controlled trials, is needed to better elucidate the true cardiovascular health effects of light to moderate alcohol consumption.
- Research is needed to identify optimal strategies to reduce alcohol consumption among heavy drinkers in order to reduce the risk of cardiovascular disease.
Citation
Piano MR, Marcus GM, Aycock DM, Buckman J, Hwang C-L, Larsson SC, Mukamal KJ, Roerecke M; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council. Alcohol use and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. Published online June 9, 2025;151:e•••–e•••. doi: 10.1161/CIR.0000000000001341