• Cardiovascular

    Mayo Clinic Q and A: Moderate alcohol intake has positive effects on heart health, but too much causes other serious health concerns

various alcoholic beverages including wine and beer

Dear Mayo Clinic:

I have read that drinking alcohol can have positive effects on the heart, but that drinking too much alcohol can damage the heart. Is this true, and if so, how much is too much?

Research has shown that drinking moderate amounts of alcohol can benefit your heart health. For most people, drinking larger than moderate amounts of alcohol does not significantly raise the risk of heart problems, but it can lead to other serious health concerns.

If you drink alcohol, the American Heart Association (AHA) recommends you limit yourself to no more than an average of one drink a day for women and two drinks a day for men. Quite a bit of attention has been given to the fact that red wine seems to be particularly beneficial. But studies have shown that the health benefits of alcohol are generally similar among wine, beer and spirits.

If you do not drink alcohol, no one recommends you start drinking it for health reasons. You can make many heart-healthy lifestyle choices that do not include alcohol.

Alcohol can have several positive effects on the body's heart and blood vessels — the cardiovascular system. First, studies have found that drinking alcohol in moderation increases your high-density lipoprotein (HDL) or "good" cholesterol, which helps carry away and break down extra cholesterol in blood that could otherwise block your arteries. Alcohol thins your blood, too, making it less likely that your arteries will form a blood clot. Moderate alcohol intake can lower inflammation throughout your body, as well, and that can also have a positive effect on your cardiovascular system.

These factors combine to result in a lower rate of cardiovascular disease in people who drink moderate amounts of alcohol than in people who do not drink alcohol at all. In addition to the heart benefits, moderate alcohol intake can slightly lower your risk of type 2 diabetes, stroke and Alzheimer's disease.

That said, alcohol use comes with risks. One of the biggest is that, over time, regularly drinking alcohol can lead to addiction. Some people assume that the AHA recommendation means they can or should have an alcoholic drink every day. That is not the case. I suggest to the people I see in my practice that they go at least a couple of days a week without alcohol, or that they take a break from alcohol for periods of time, as a reality check to make sure they are not becoming dependent on it. Alcoholism develops over time as people get into a habit. As tolerance for alcohol increases, consumption often rises as well. You need to be cautious not to fall into bad habits with alcohol, because the consequences can be severe.

Regularly drinking more than moderate amounts of alcohol can lead to many health problems. The overall risk of cardiovascular disease does not rise significantly in most people when they drink more than the recommended amount of alcohol. Some people, however, can develop heart failure from increased alcohol consumption. In addition, too much alcohol may raise your blood pressure and triglyceride levels. Both can put you at higher risk for heart disease.

Drinking too much can increase your risk for a host of cancers, including liver, stomach, breast, colon and oral cancer. It raises the likelihood that you could develop inflammation in your pancreas and in the lining of your stomach, and it increases your risk of cirrhosis — a serious liver disorder. All told, drinking alcohol in excess is the third-leading cause of preventable death in the United States.

Clearly, drinking alcohol has some benefits. But there also are some very real risks. If you choose to drink, be mindful about it and always drink in moderation.

— Donald Hensrud, M.D., Preventive Medicine, Mayo Clinic, Rochester, Minn.