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Is Alcohol Really Good for Your Heart?

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R. Todd Hurst, MD, FACC, FASE - Blogs
By R. Todd Hurst, MD, FACCBoard-certified cardiologistJune 07, 2019

You’ve probably heard in the media, and maybe from your doctor, that a “moderate” amount of alcohol is good for your heart. But more recent research has called that into question. In fact, this new information has made me re-think the way I talk to my patients about alcohol and heart health.

Alcohol and Heart Disease

The research on alcohol and its effect on our health has limitations. Most studies depend on self-reporting to determine the amount of alcohol intake (which reduces chances of accuracy) and these studies don’t usually take into account changes in alcohol intake over a lifetime.

Despite the complexities around the research, what is clear is that heavy alcohol use (more than 14 drinks per week for men, 7 drinks for women) can cause heart problems such as a weak heart muscle or atrial fibrillation.

But research has also consistently suggested that drinking some alcohol could actually lessen the risk of heart attack. So the question has been, what is the right amount of alcohol for heart health?

What is the sweet spot?

For years we’ve thought that drinking a “moderate” amount would put you in that target zone – that meant up to 2 drinks a day for men and 1 drink per day for women. However, more recent research has suggested that a safe amount of alcohol may actually be half of that.

What the Newest Research Tells Us

Two studies recently presented at the American College of Cardiology meeting questioned the idea that moderate levels of alcohol lead to healthy hearts. The first study of over 17,000 US adults showed that 7-13 drinks per week increases the risk of having high blood pressure by 53%, and doubles the risk of stage 2 hypertension (blood pressure > 140/90 mm Hg). This is interesting information because, although it has been known for a long time that heavy alcohol use can raise blood pressure, this is one of the first studies to show that even moderate alcohol use can impact blood pressure significantly. 

The other study looked at atrial fibrillation (Afib) and alcohol use. In this study, moderate drinkers (> 10 drinks/week) with Afib were randomly split into two groups: one continued to drink moderately, while the other group drank no alcohol (well, almost – they still had 2 drinks a week on average). After 6 months, those who had been drinking little to no alcohol had 37% less Afib and lost more weight compared to those who continued to drink in moderation.

You may have heard about the large study published in Lancet with the conclusion that the safest amount of alcohol is zero. A closer look at the data shows that health risks didn’t actually increase significantly until after about a drink per day (it was also interesting to note that those who drank less than 1 drink a day didn’t experience a health benefit).

Re-thinking Recommendations

Based on this newer information, what will I tell my patients about alcohol and their heart?

I used to say that 1-2 drinks per day wouldn’t affect their heart, but more than that might. Now, I will explain what we know and don’t know and emphasize that while the available data is not definitive, the best evidence suggests that about ½ an alcoholic drink a day may boost health (but that no one should drink just for the health benefits).

For my patients with high blood pressure, I will emphasize that limiting alcohol to less than 7 drinks per week may help lower their blood pressure. And for my patients with Afib, I will let them know that no alcohol may be the best option.

The questions around alcohol and health will continue to be complex and the answers will depend on the person. If you drink alcohol, talk to your doctor about how much is right for you.

Dr. Hurst gratefully acknowledges the contribution of Alexandra Winski in the creation of this article.

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About the Author
R. Todd Hurst, MD, FACC

R. Todd Hurst, MD, FACC, FASE, is a board-certified cardiologist, director of the Center for Cardiovascular Health at Banner – University Medicine Heart Institute, and associate professor of medicine at the University of Arizona. He has written more than 50 publications in peer-reviewed journals and regularly speaks nationally and internationally at medical meetings, primarily on the prevention of heart disease.

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