Alcohol and the heart

It's no secret that drinking alcohol comes with risks to your health. But how does it affect your heart? Here we separate the facts from the fiction. We offer plenty of advice, tips, and ideas to help you reduce or remove alcohol.

There’s strong evidence that drinking alcohol increases your risk of high blood pressure, a significant risk factor for heart disease

Our position statement

The Heart Foundation has reviewed the latest evidence on alcohol. We share our findings to help you understand what’s best for your health. In developing our recommendations, we considered the wider effects of alcohol use on whānau and communities. 

Position statement download

When we talk about alcohol, we mean all the different types of alcohol. This includes beer, wine, cider, RTDs (Ready to Drink) and spirits.  

Our position statement excludes alcohol found in foods and non-alcoholic drinks (like kombucha).  

How alcohol affects the heart

Alcohol can affect your heart in many ways (1):  

• It impairs the function of the endothelium. This is the thin layer of cells lining the inside of the heart and blood vessels. 
• It increases your heart rate. 
• It's linked to increased blood pressure. 

No amount of alcohol is good for your heart

The Heart Foundation doesn’t recommend drinking alcohol to improve heart health.  

The latest evidence shows that alcohol increases the risk of high blood pressure. High blood pressure is a major risk factor for heart disease and stroke. There is strong evidence that every 10g increase in pure alcohol per day (equal to 1 standard drink) raises the risk of high blood pressure by 6%. (2)  

 Alcohol increases your risk of atrial fibrillation and haemorrhagic stroke. It may also increase your risk of heart failure and ischaemic heart disease (3). 

 The bottom line?  

 There is no safe level of alcohol consumption.  

 If you currently don’t drink any alcohol, then don’t start drinking. If you do drink alcohol – it’s better to drink less.  

Can I drink alcohol if I have a heart condition?

If you know you’ve got high blood pressure, you can make lifestyle changes to help to lower it by

• reducing your alcohol intake
• moving your body
• lowering your salt intake.

People with heart conditions, such as atrial fibrillation (AF) or heart failure should aim to drink less alcohol or avoid it altogether.  

There is emerging evidence that for people with AF, reducing or removing alcohol can decrease the likelihood of AF recurring.  

Alcohol may change the way some medications work or make them less effective. Talk to your doctor or pharmacist for advice on whether it’s safe for you to drink alcohol.  

The advice on alcohol consumption has changed

For many years, there has been a belief that drinking alcohol in moderation is acceptable. That it offers protection against heart disease and that red wine is good for the heart. We now know this is not the case. 

Recent evidence has become stronger and clearly indicates that any amount of alcohol consumption raises the risk of heart disease. It doesn’t matter whether it’s wine, beer, cider or spirits – it’s all still alcohol.  

What about red wine?

It’s a commonly held belief that ‘a glass of red wine a night is good for your heart’. This has come about because red wine contains antioxidants like resveratrol. Yet, our latest advice is that red wine is the same as any other type of alcohol. You should not consume it for heart health benefits. 

The traditional Mediterranean diet is known to include small amounts of alcohol with meals. This eating pattern is well-researched. The evidence shows a small positive impact on heart disease risk factors, such as blood pressure and cholesterol (3). However, it’s important to note that the evidence is for the total eating pattern. The effects of alcohol cannot be separated from the health benefits of the overall diet. Alcohol is not a defining feature of a heart-healthy eating pattern and is not recommended for heart health. 

What are the benefits of drinking less?

The benefits of drinking less alcohol extend beyond heart health.  

Other benefits may include: 

• saving you money 
• improving your sleep quality  
• improving your memory and concentration  
• helping you to manage your weight due to alcohol being high in kilojoules (calories) 
• helping you to manage or improve your mental health.  

Drinking less alcohol also reduces your risk of a wide range of health conditions, including breast and bowel cancer (4).

Tips to drink less

For many people, making the commitment to drink less alcohol is hard to do. The good news is you can gradually reduce your drinking over time. Any steps you can take to reduce the amount you drink will benefit your heart health. Chat with your friends and whānau, as you’ll need their support.  

Try the following: 

• Have alcohol-free weeks and weekends wherever you can.  
• Choose alcohol-free activities or make your usual activities alcohol-free. 
• Drink slowly. 
• For every drink of alcohol, have a drink of water or soda water. 
• Try having ‘low’ or ‘zero’ alcohol products in place of full-strength drinks. 

What can I drink instead of alcohol?

We’ve got you covered with plenty of alternatives to alcohol that will keep you hydrated too. If you’re having alcohol alternatives, always look for options that are low in sugar.  

• Water is the best drink and is usually free when you’re out and about. 
• Make a delicious, warming drink like our peach cinnamon delight. It's perfect during the winter months.
• Add a twist of flavour to still or sparkling water with slices of fruit, cucumber and fresh herbs. Here are our favourite infused water combinations .  
• Try our ideas for iced teas. These are made using black or herbal tea bags with fresh ingredients added for extra flavour. 
• If you have the time, try making a mocktail like our tasty non-alcoholic cool mint crush mojito.
• Keep a selection of non-alcoholic drinks handy, like flavoured sparkling waters. These can be great to have on hand.

What is the difference between zero, low-alcohol and low-carb drinks?

These products are now widely available. Remember, some products may be marketed as 'low in sugar' or 'low carbs' and can create what is called the ‘health halo’. Some of these drinks may have lower energy and carbohydrates but usually contain the same amount of alcohol. When making a choice, it’s always a good idea to check the nutrition information on the label. 

Here’s what they mean:  

• ‘Zero alcohol’ or ‘alcohol-free’ contains less than 0.5% alcohol by volume (ABV).  
• ‘Low alcohol’ contains less than 1.15% alcohol by volume (ABV). 
• ‘Light’ must have 25% less energy (calories/kilojoules) than the standard version.  
• ‘Low carb’ contains fewer carbohydrates and calories/kilojoules than the standard version. But these drinks usually contain a similar amount of alcohol.  
• ‘Refined sugar-free’ isn’t a regulated term. It means that the product is sweetened with ‘natural’ sugars. This doesn’t necessarily mean it is low in sugar. 
• ‘Pregnancy warning’. Drinks containing more than 1.15% alcohol by volume (ABV) must include a warning of the harm to your baby (by 1 August 2023). 

Is it better to stop drinking or cut down?

Choosing whether to stop drinking or cut down is your decision. Any reduction in your alcohol intake will benefit your heart health. In fact, people who drink the most have the most to gain by reducing their alcohol consumption. 

Reducing the amount of alcohol you drink can result in improvements in your: 

• liver function 
• blood pressure 
• the way your body responds to the hormone insulin 
• cancer-related growth factors (5).  

If you are drinking six or more standard drinks a day and want to stop drinking, it’s important to talk to your doctor first. Suddenly stopping drinking can be a risk to your health. 

Where can I get support to stop drinking?

Use this Alcohol Risk Assessment Tool to find out the effect your alcohol consumption has on your health and wellbeing. Talk to your doctor or health professional about your results. 

If you are ready to chat to someone and want free support, contact the Alcohol Drug helpline 24/7 on 0800 787 797. Or visit support.alcohol.org.nz for a list of services available throughout Aotearoa. 

How can I wind down or relax without alcohol?

If you drink alcohol to relax after a stressful day, think about how you can change this to a healthier habit.  

It’s easy to get into the habit of having a drink as soon as you get home from work but it’s just as easy to form a new habit.  

Here are some of our favourite ways to relax without alcohol:  

• Go for a short walk. 
• Do a yoga or pilates class. 
• Phone a friend or member of your whānau. 
• Read a book or magazine. 
• Listen to an audiobook or podcast. 
• Have a bath or shower. 
• Listen to music. 
• Try guided meditation or mindfulness. 

The good news is that it doesn’t take long to form a new habit. The bonus is you’re likely to feel the difference due to better sleep and feeling refreshed the next day.

How can I still be social without alcohol?

Regularly connecting with people is crucial for our mental, emotional and physical health. However, you can still socialise without alcohol or while drinking less. It’s a good idea to let people know that you’re not drinking or aiming to drink less so that they can support you. 

When arranging to catch up with friends and family, focus on food or an activity. Examples could include a bush walk, pot-luck dinner, picnic or sporting activity.  

How do I support someone to drink less alcohol?

It can be hard to know where to start if you’re worried about someone else’s drinking. If you’ve noticed that someone close to you is drinking too much, there are ways to approach them about it. This booklet is a helpful guide: Concerned about someone’s drinking?

What if I have a teenager who drinks alcohol?

People under 18 years of age should not drink alcohol. This is to reduce the risk of alcohol-related injury and harm. The brain is still developing until around 25 years of age. Teenage brains are more sensitive to damage from alcohol.  

If you’re a parent of a young person, it’s ideal to delay alcohol use as long as possible. Research indicates that the longer a person delays drinking, the greater their protection against alcohol-related harm throughout their lifetime.  

What if I’m pregnant or breastfeeding?

If you are pregnant, breastfeeding or trying to conceive, abstaining from alcohol is the safest choice for both you and your baby. 

Drinking any alcohol while pregnant increases the risk of: 

• miscarriage 
• stillbirth 
• preterm birth 
• Foetal Alcohol Spectrum Disorder (FASD).  

It may also increase the risk of congenital heart disease in your baby. 

Alcohol position statement

How much do you know about alcohol? Try our quiz

References

1. Andreasson S CT, Dangardt F, Holder H et al. Alcohol and Society 2023: Alcohol and blood pressure. Stockholm: Swedish Society of Nursing, SFAM, SAFF, CERA, The Swedish Society of Addiction Medicine, SIGHT, Movendi International, Swedish Heart and Lung Association, SLAN & IOGT-NTO 2023.
2. Liu F, Liu Y, Sun X et al. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2020;30(8):1249-59.
3. Paradis C BP, Shield K, Poole N et al. Low-Risk Alcohol Drinking Guidelines Scientific Expert Panels. Canada’s Guidance on Alcohol and Health: Final Report. Ottawa Ontario: Canadian Centre on Substance Use and Addiction; 2023.
4. Estruch R, Ros E, Salas-Salvadó J et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.
5. Rees K, Takeda A, Martin N, Ellis L et al. Mediterranean‐style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews. 2019(3).
6. Karam G, Agarwal A, Sadeghirad B et al. Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis. BMJ. 2023;380:e072003.
7. Pathways ARCH. Alcohol screening and intervention 2023 [Available from: https://aucklandregion.communityhealthpathways.org/16539.htm].
8. Morton S, Atatoa Carr P, Bandara D et al. Growing Up in New Zealand: A longitudinal study of New Zealand children and their families. Report 1: Before we are born. Auckland Growing Up in New Zealand; 2010.