The controversy over alcohol consumption: Is it good or bad for your heart?

If you go to a party or a professional event, you won’t be surprised to find that alcoholic beverages are served. In fact, in most cases, it’s even expected. Alcohol consumption has been present throughout human history. So do its effects. Excessive drinking has been linked to many health risks, including high blood pressure, heart diseases, stroke, liver diseases, and digestive problems. However, the health effects of light-to-moderate drinking are still in dispute (1). Early evidence showed that light-to-moderate drinking is associated with beneficial effects such as reductions in coronary artery diseases and even in total mortality. This view has been challenged by a few recently published epidemiological studies, which show no direct relationship between the beneficial effects on the heart and light-to-moderate drinking (2).

What is light/moderate drinking?

According to National Institute on Alcohol Abuse & Alcoholism, moderate drinking is up to four alcoholic drinks for men and three for women in any single day and a maximum of 14 drinks for men and 7 drinks for women per week. Below that range would be considered light drinking.

Why is there a discrepancy in health risks reports on alcohol consumption?

The obvious:

Confounding factors such as social-economic status, age, genetics, ethnicities, behavior and types of alcoholic beverages play big roles in influencing health effects. It’s not hard to imagine that a wealthy family has more medical resources and more options of choosing a healthy lifestyle, which has lower risks of cardiovascular diseases compared to a low social-economic status family that even consumes the same amount of alcohol. The alcohol metabolism rate differs in different age groups and different populations. The certain population lacks an enzyme, alcohol dehydrogenase, which metabolizes alcohol, that has adverse health effects when drinking alcohol. These confounding factors are important when conducting an epidemiology study. Not all alcoholic drinks are created equal. Bioactive phytochemicals, for example, polyphenols have beneficial effects which can be found in wines. Cocktails usually contain a large amount of sugar, and high sugar consumption are linked to many cardiovascular disorders. It’s hard to tease out the causal effects of light-to-moderate alcohol consumption and the health effects. Moreover, most of the reported works of literature are observational, which leads to more complications when trying to interpret the data.

The less obvious:

Epidemiological study design has evolved rapidly in recent decades. Early studies were focused on interpreting results from limited resources. The lack of enough participants and missing specific details make it impossible to make a causal connection between alcohol consumption and health risks. In 2007, researchers started to encourage epidemiological studies to use large, prospective, and randomized trials when trying to understand the health effects of drinking (3). A recent review just published in Circulation: Heart failure questioned the relationship between alcohol intake and cardiomyopathy and heart failure (4). After analyzing current evidence, they suggest that there is no consensus on the absolute amount alcohol intake which causes cardiomyopathy and heart failure. Another group showed that low alcohol intake has no health benefits, and moderate alcohol intake is associated with adverse effects in heart (5).

To drink or not to drink. There is no one-size-fits-all solution. The jury is still out when it comes to the health effects of light-to-moderate drinking. Monitor your health and consult with your doctor regularly. If it’s not good for you, your body will tell.


  1. Piano, M. R. (2017). Alcohol’s Effects on the Cardiovascular System.Alcohol Research : Current Reviews38(2), 219–241.
  2. Biddinger, K. J., Emdin, C. A., Haas, M. E., Wang, M., Hindy, G., Ellinor, P. T., Kathiresan, S., Khera, A. v, & Aragam, K. G. (2022). Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease.JAMA Network Open5(3), e223849–e223849.
  3. Kloner, R. A., & Rezkalla, S. H. (2007). To Drink or Not to Drink? That Is the Question.Circulation116(11), 1306–1317.
  4. Andersson, C., Schou, M., Gustafsson, F., & Torp-Pedersen, C. (2022). Alcohol Intake in Patients With Cardiomyopathy and Heart Failure: Consensus and Controversy.Circulation: Heart Failure0(0), 10.1161/CIRCHEARTFAILURE.121.009459.
  5. The abstract ‘Moderate alcohol consumption is associated with progression of left ventricular dysfunction in a European stage B heart failure population’ will be presented during the session ‘Heart failure is a complex syndrome: look at comorbidities’ which takes place on 22 May at 09:40 CEST at Moderated ePoster 1.

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