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Cardiovascular benefits and risks of moderate alcohol consumption

Christine C Tangney, PhD
Robert S Rosenson, MD
Section Editor
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Deputy Editor
Daniel J Sullivan, MD, MPH


Excessive alcohol use can lead to a variety of adverse effects including liver disease, heart failure, increased cancer risk, neurologic complications, and unintentional injuries. Balanced against these deleterious effects is the observation that, compared with abstinence or heavy drinking, moderate alcohol intake may have health benefits, particularly in regard to coronary heart disease (CHD). The cardiovascular benefits and risks of alcohol consumption, as interpreted based on data from observational studies, will be reviewed here.

A discussion of the issues surrounding alcohol intake in a broader perspective is found separately. (See "Overview of the risks and benefits of alcohol consumption" and "Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis".)


Few randomized trials assigning participants to specified doses of alcohol have been performed. Limitations in studies of alcohol consumption are discussed elsewhere. (See "Overview of the risks and benefits of alcohol consumption", section on 'Limitations of the evidence'.)

Definitions of a "standard drink" differ, both within and between countries (figure 1) [1,2]. The definitions of a "standard drink," "moderate drinking," and "heavy drinking" are discussed in detail elsewhere. (See "Overview of the risks and benefits of alcohol consumption", section on 'Definitions'.)


Several prospective cohort studies suggest that light to moderate alcohol consumption decreases the risk of coronary heart disease (CHD) by 40 to 70 percent, compared with drinking no alcohol or to heavy alcohol intake [3]. A 2011 meta-analysis of 84 observational studies found that, relative to nondrinkers, alcohol drinkers had a relative risk (RR) of 0.75 (95% CI 0.70-0.80) for cardiovascular disease mortality, 0.75 (0.68-0.81) for CHD mortality, and 0.71 (0.66-0.77) for incident CHD [4]. Different results showing no net benefit on all-cause mortality have also been reported [5].

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