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If you’re living with heart disease, you may have read or heard confusing information about whether it’s safe to drink alcohol — and if so, how much. There are many types of heart conditions, and several factors affect how your body responds to alcohol, so there’s no one-size-fits-all recommendation regarding how much to drink.
Recent evidence suggests that any amount of alcohol raises heart disease risk, and research findings showing heart health benefits may have been skewed by characteristics associated with lighter drinking, like an overall healthy lifestyle. Frequent or heavy drinking is dangerous for people with heart failure and is a known risk factor for multiple cardiovascular diseases, including stroke and heart attack.
Nonetheless, studies show that low or moderate drinking may be helpful for reducing inflammation and raising levels of high-density lipoprotein (HDL) cholesterol — which is known as the “good kind” of cholesterol. Limited alcohol consumption may also protect against hypertension (high blood pressure).
Here are some factors to consider when deciding whether drinking alcohol fits into your cardiovascular health plan.
Several members of MyHeartDiseaseTeam continue to drink alcohol with heart disease, and many don’t think it negatively affects their health. “I have two glasses of wine with dinner every night,” one member said. “I don’t believe it hurts me. l enjoy it and won’t give it up. There’s not much left that I enjoy.”
Another shared, “I have been on the Mediterranean diet for two months now, which recommends one glass of red wine with dinner. I’m not a big drinker, but I gotta follow my diet! :)”
Although there’s evidence that light to moderate drinking can be good for heart health, some researchers believe these benefits may have been overestimated. People with existing heart diseases need to consider the pros and cons of drinking based on their specific diagnosis and advice from their health care provider.
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It’s fine to continue moderate alcohol consumption if you get the OK from your physician. General guidelines advise no more than one drink a day for women and two or fewer for men, according to Johns Hopkins Medicine. One drink in this context means, 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof spirits.
Excessive drinking isn’t healthy for anyone. Heavy drinking contributes to:
It’s important to remember that even if you don’t drink frequently, drinking a lot at once is dangerous. The Centers for Disease Control and Prevention (CDC) defines heavy drinking as eight or more drinks a week for women and 15 or more a week for men. Having several drinks on a single occasion — or binge drinking — can also be a problem. The CDC defines a binge as four or more drinks for women and five or more for men.
One MyHeartDiseaseTeam member said, “I was told a two-beer limit or one glass of wine. I went to a meeting the other week and had four, and it didn’t feel good. Take my word for it. Stick with what they tell you.”
If you don’t drink, health experts recommend not starting. Also, note that general recommendations don’t apply to everyone — some people shouldn’t drink at all.
Even if you don’t give up alcohol completely, decreasing your intake has potential benefits.
One MyHeartDiseaseTeam member shared their thoughts on reducing alcohol consumption: “My advice is to think about activities that give you pleasure without alcohol. I can go out with friends and let my hair down just as well with alcohol-free drinks as I used to do with beer, wine, or spirits.”
Another member sets limits and dilutes the alcohol. “I partake once a week, maybe, and it is mixed with lemonade. It takes away any cravings I have,” they said.
If you’re interested in cutting back, you can start by taking nights off from drinking or measuring your drinks to make sure you follow the recommended limit. Drinking more water and switching up your routine, like taking a walk after dinner instead of having an alcoholic drink, can help you succeed. Ask a friend to join you in drinking less — they can support you and keep you accountable.
People often connect having a drink with other situations or habits they’re trying to change. For instance, if you’d like to quit smoking, lose weight, or maintain a healthy diet, avoiding alcohol might help you achieve your goal.
A few MyHeartDiseaseTeam members stopped drinking because they associated alcohol with activities that aren’t heart-healthy. “I used to enjoy cigars and alcohol, and I’m so happy to say ‘used to.’ I know that they contributed to my heart failure in 2017,” one member said.
Another shared, “I used to enjoy a glass of wine with a steak maybe once a month, but now, I can’t remember when I had either one. I’m not eating red meat very often anymore.”
You may need to stop drinking if alcohol directly affects your specific type of heart disease. For instance, cardiologists typically encourage people with heart rate abnormalities or heart failure to stay away from alcohol.
Alcohol may also interact with some treatments for heart disease and lead to harmful effects. Many types of medications may interact with alcohol, including the following:
Talk with your doctor to find out if you can safely drink alcohol on your treatment plan for heart disease. Ask your pharmacist if any of your medications that you take interact with alcohol.
In addition, it’s not safe to drink with certain comorbidities (coexisting health conditions), like cancer or liver disease.
Some members of MyHeartDiseaseTeam have said that they quit drinking for health reasons or because they didn’t like how alcohol was affecting them. One member wrote, “I used to love a glass of wine occasionally, but it seemed to make my atrial fibrillation worse.”
Another offered a similar sentiment: “My heart pounds after relatively small amounts of alcohol. It keeps me awake at night, which is a bit scary. I don’t drink anymore — it’s simply not worth it.”
One member described learning the hard way to follow their doctor’s advice. “While I was in the hospital with congestive heart failure, the physician instructed no alcohol, period. I was a nonbeliever and continued to drink,” they said. “Soon after, I had an uncontrollable, panic-like attack that required a trip to the ER. The medicine conflicted with the alcohol, and I almost died in the ER. I quit and have not had any alcohol for a year.”
Don’t risk your life by drinking against your doctor’s advice. Instead, get help to quit so you can stay safe.
Sometimes giving up alcohol isn’t as easy as you might expect. If you’re struggling with a physical or psychological dependence on alcohol, you may need help to stop drinking.
Ask your cardiologist for local resources, such as a support group or social worker. You can also contact the American Addiction Centers helpline by phone or text. In addition, the Substance Abuse and Mental Health Services Administration has a national helpline that’s available anytime, any day at 800-662-HELP (4357). Be assured that if you want to cut back on or quit drinking, you can get the help and support you need.
MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 56,000 members come together to discuss life with heart disease and share their experiences.
How does living with heart disease affect your alcohol use? Do your cardiovascular disease symptoms seem to change when drinking alcohol versus abstaining? Post your story in the comments section or discuss this topic on your Activities page.
Steven Kang, M.D. is the Director of Cardiac Electrophysiology at Alta Bates Summit Medical Center and Alameda Health Systems in Oakland, California. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.
