Effects of Alcohol on the Cardiovascular System
How Does Alcohol Affect the Cardiovascular System?
The cardiovascular system is involved with a number of physiological functions and plays a vital role in sustaining life and maintaining overall health. It comprises the heart and blood vessels, the latter of which include arteries, veins, and capillaries.1
Also known as the circulatory system, the cardiovascular system ensures the transport of oxygen and nutrients to vital organs and tissues, as well as the shuttling of metabolic wastes to the liver and kidneys for removal from the body. While the heart propels oxygen-rich blood, the vessels help to regulate blood pressure and provide pathways for this blood to travel throughout the body.2
A significant body of research suggests that alcohol use can have complicated and potentially detrimental effects on the heart and the body’s blood vessels.3 In fact, studies indicate that heavy alcohol intake is associated with increased risks of cardiovascular conditions such as hypertension, arrhythmia, cardiomyopathy, and strokes—many of which can lead to further health complications.3,4
The effects of alcohol on the cardiovascular system are dose-dependent, as the more chronic and heavy the alcohol consumption, the greater the risk of cardiovascular disease.3 So while long-term heavy drinking is associated with cardiovascular diseases, even acute episodes of binge drinking can also be harmful, as binge drinking is linked to transient arterial hypertension, myocardial inflammation, decreased cardiac contractility, and a variety of arrhythmias.3,5
Alcohol’s Impact on Hypertension
Hypertension (aka high blood pressure) is a serious medical condition characterized by persistent elevations in blood pressure. The pressure that’s measured when the heart contracts to pump blood is systolic blood pressure, which is the top number in a blood-pressure reading. Meanwhile, the bottom number is the diastolic pressure, which is the amount of pressure in the blood vessels when the heart relaxes.
Though guidelines have changed over the years, many healthcare organizations in the U.S. recognize stage 1 hypertension as blood pressure that’s consistently greater than 130/80, with stage 2 hypertension beginning at pressures above 140/90.6
Research has shown that regular alcohol consumption is linked to hypertension in a dose-dependent manner.3,4 While low to moderate alcohol consumption in healthy adults appears to have no acute or substantial impact on blood pressure, chronic alcohol use can lead to hypertension.4,8,9
Additionally, binge drinking is associated with increases of 4 to 7 points for systolic pressure and 4 to 6 points for diastolic pressure. To provide some context for this data, population studies suggest that a blood pressure increase of just 2 points (2 mmHg) may be associated with an increased mortality from stroke by 10 percent and from coronary artery disease by 7 percent.8
Chronic hypertension can lead to progressive damage to the cardiovascular system over time, which increases the risk of developing several potentially life-threatening conditions.10 According to the American Heart Association, health threats related to unmanaged high blood pressure include:10
- Heart attack.
- Stroke.
- Heart failure.
- Kidney disease/failure.
- Vision loss.
- Sexual dysfunction.
- Angina (i.e., chest pain).
- Peripheral artery disease (PAD).
AFib and Alcohol Consumption
Atrial fibrillation, also known as AFib, is an arrhythmia characterized by irregular and/or rapid heart rhythm originating in the upper chambers of the heart known as the atria. When AFib occurs, the heart’s upper and lower chambers don’t work together properly. As a result, the lower chambers may not fill completely or pump enough blood to the body. While AFib causes no symptoms in some people, others may experience fatigue, lightheadedness, dizziness, shortness of breath, and/or chest pain, or they may feel as if their heart is skipping a beat, fluttering, pounding, and/or beating too hard or fast.11
Binge drinking and chronic alcohol consumption are associated with acute arrhythmias such as AFib, even in those who have an otherwise normal heart function.3,4,5 In fact, there’s a term—namely, holiday heart syndrome—to describe acute disturbances in heart rhythm after heavy alcohol consumption over a long weekend.4
Additionally, some people may experience arrhythmias such as AFib during alcohol withdrawal as the body adjusts to the absence of the substance.12 Thus, it’s important to seek professional help to detox from alcohol and to monitor for heart safety during alcohol withdrawal.
When undetected or left untreated, AFib can lead to serious health complications such as blood clots, cognitive impairment/dementia, heart failure, stroke, and cardiac arrest.13 Some evidence suggests that heavy drinking increases the risk of sudden cardiac death, and fatal arrhythmias such as AFib are the most likely cause.14
Alcoholic Cardiomyopathy
Alcoholic cardiomyopathy is a heart muscle disorder characterized by enlargement of the heart wall, dilatation of its chambers, and associated low cardiac output.4 Although some people are asymptomatic, alcoholic cardiomyopathy symptoms can include:15
- Shortness of breath.
- Difficulty breathing while lying flat (i.e., orthopnea).
- Sudden episodes of shortness of breath during sleep (i.e., paroxysmal nocturnal dyspnea).
- Palpitations.
- Fainting episodes.
Alcoholic cardiomyopathy can also present with certain signs of congestive heart failure such as:15
- Swelling in the lower extremities.
- Abnormal fluid distribution in the body (i.e., third spacing).
- Liver enlargement.
- Visible bulging of jugular veins.
Excessive alcohol consumption is a main cause of alcoholic cardiomyopathy, a type of nonischemic dilated cardiomyopathy.5,14 In fact. alcoholic cardiomyopathy accounts for up to 50% of all cardiomyopathy cases in Western countries.4
While the precise amount of alcohol associated with the development of the condition is unknown, alcohol misuse can lead to cardiomyopathy in several ways.8 For example, alcohol may be toxic to certain metabolic and synthetic cardiac muscle cell processes, which can progressively impair cardiac health. The damage to these cardiac muscle cells impairs the heart’s ability to contract properly, which impacts its ability to pump blood throughout the body. In addition, alcohol disrupts the balance of calcium in the body, which is a vital mineral that supports normal and healthy heart contractions.4
While some cases of alcoholic cardiomyopathy can be reversed with abstinence, severe cases can lead to congestive heart failure even after the individual stops drinking.4 Particularly for those with alcoholic cardiomyopathy who continue to drink, the condition can increase the risk of potentially lethal complications such as:15
- Cardiac embolism.
- Arrhythmias.
- Heart failure.
- Cachexia (i.e., a metabolic syndrome characterized by muscle wasting, weight loss, and a decline in physical function).
Alcohol’s Link to Coronary Artery Disease, Heart Attack, and Stroke
A rather complex relationship exists between alcohol and strokes, heart attacks, and coronary artery disease. While scientific data provides strong cardiac conclusions in some cases and weaker connections in others, suffice it to say that depending on a host of variables, alcohol can be harmful in relation to these conditions. In many cases, chronic or heavy drinking is most detrimental. However, single episodes of heavy or binge drinking are also associated with cardiovascular mortality.14
Coronary Artery Disease
The most common type of heart disease in the U.S., coronary artery disease (CAD) is caused by a buildup of plaque in the walls of arteries that supply blood to the heart. Over time, this leads to atherosclerosis, which is when the plaque buildup narrows the inside of the arteries, limiting or blocking blood flow. The main symptom of CAD is chest pain. However, for many people the first indication that they have CAD is a heart attack.16
When it comes to alcohol consumption, though some studies suggest an association between light to moderate drinking behavior and certain cardioprotective results, the conferred benefits definitely don’t extend to heavier drinking behaviors. That is, regular heavy drinking as well as episodes of heavy drinking peppered amid ongoing light to moderate drinking are associated with an increase in coronary artery disease.9
In addition to heart attacks, CAD can lead to various complications, such as a weakened heart muscle and heart failure (i.e., when the heart can’t effectively pump enough blood to the rest of the body).16
Stroke
A stroke is actually a type of neurological disease, though the risk of this potentially catastrophic event is often tied to certain cardiovascular conditions. A stroke occurs when blood flow to the brain is blocked or sudden bleeding in the brain occurs. This then leads to a lack of oxygen and nutrients, which causes brain cells to begin to die within minutes. This medical emergency can cause long-term disabilities, brain damage, and death.17
Signs of a stroke include mild weakness, paralysis, and/or numbness on one side of the body or face as well as sudden and severe headache, weakness, and/or difficulty seeing, speaking, and/or understanding speech.17
There are two types of strokes, each of which has a slightly different relationship with alcohol:4,9
- Ischemic stroke, which accounts for 80 percent of cases, is caused by a blockage in a blood vessel in the brain typically due to a clot that originated elsewhere in the body.
- Hemorrhagic stroke, which accounts for 20 percent of cases, is caused by a rupture of a blood vessel to the brain.
Smoking and hypertension are major risk factors for ischemic stroke, which occurs most commonly in elderly populations. The connection between alcohol and ischemic stroke occurs mostly in relation to other cardiovascular problems, such as hypertension, arrhythmias, coronary artery disease, and alcoholic cardiomyopathy.4
Heavy alcohol consumption is associated with blood-clot-related ischemic stroke. The increased risk is likely linked to alcohol-related AFib and cardiomyopathy, which can both predispose people to the formation of blood clots or the spread, growth, or transmission of existing clots. These clots can then dislodge and block blood flow to the brain, causing a stroke.4
When it comes to the less common hemorrhagic stroke, both chronic and heavy alcohol consumption are associated with an increased risk of bleeding in a part of the brain called the cerebrum and in the space surrounding the spinal cord and brain. According to at least one study, chronic heavy drinkers have at least twice the risk of bleeding in the brain compared to nondrinkers.4
Heart Attack
A heart attack (aka cardiac arrest) occurs when the heart suddenly stops pumping blood. The main causes of this medical emergency are various types of arrhythmias.18
As mentioned earlier, heavy and chronic alcohol consumption—along with physical exertion, stress, substance misuse, and more—are linked to arrhythmias such as AFib.3,19 In fact, according to data from the National Heart, Lung, and Blood Institute, 3 out of 20 cardiac arrests are linked to alcohol consumption.19
How Much Alcohol Is Too Much?
The Centers for Disease Control and Prevention (CDC) defines low-risk drinking as up to 1 standard drink per day for women and up to 2 standard drinks per day for men.20 However, many experts believe that given its negative effects, alcohol should be avoided even in moderation.3 Additionally, even those who generally stay within the CDC guidelines for low-risk drinking can experience significant harm from a single episode of binge drinking.21
For many people, healthcare professionals recommend abstaining from alcohol to avoid both long-term and short-term effects on the cardiovascular system. For those who have cardiomyopathy, complete abstinence is vital to prevent further damage to the heart muscle and to improve cardiac function.3
Can You Reverse Damage to the Cardiovascular System?
While some types of cardiovascular damage may be permanent even with abstinence—such as severe cases of alcoholic cardiomyopathy—other negative cardiovascular effects may be reversible.4 For example, hypertension has been shown to be significantly reversible in the majority of heavy drinkers once they’ve experienced an extended period of withdrawal.22
As with most forms of disease, a healthy lifestyle—including a proper diet, exercise, minimal stress, and low or moderate levels of alcohol consumption or abstinence—can work to promote healing.
If you or a loved one is struggling with alcohol misuse and/or you’re concerned about the possible effects alcohol can have on cardiovascular health, help is available. American Addiction Centers offers multiple treatment centers throughout the U.S., providing everything from alcohol detox and inpatient treatment to outpatient care, telehealth treatment, and aftercare.
Our admissions navigators also offer an empathetic ear and tons of treatment-related insight to help get you on the road to recovery. Reach out to us at to learn more about treatment, admissions, and how to take your first steps toward recovery today.
