How does alcohol help the heart?

The key mechanism for alcohol’s protective effect is its impact on HDL cholesterol. Higher levels of HDL (the good cholesterol) are associated with reduced risk of heart disease. Moderate alcohol consumption increases HDL by about 12 percent. By way of comparison, this extent of increase in “good” cholesterol is similar to the effect of an aerobic exercise program.

A second property of alcohol that may reduce risk of heart attacks is its impact on blood clotting. Alcohol reduces blood clotting by reducing the viscosity or thickness of the blood, as well as by reducing the actions of platelets and certain proteins that cause blood to clot. This likely reduces the risk of clot formation in the heart’s arteries, which is the chief cause of heart attacks.

Alcohol and sex

Alcohol has different health effects on women and men. The effects of alcohol, both beneficial and adverse, occur at lower levels of intake in women. Thus, a woman drinking the same amount of alcohol as a man will wind up with a higher blood alcohol concentration, a result of her lower body weight and the fact that she metabolizes alcohol more slowly. While this may not seem fair, it is a medical fact.

We have a special note of caution for women. A recent study suggested that alcohol increases a woman’s risk of developing breast cancer, liver cancer and rectal cancer. A woman with a personal history of one of these cancers or with a high risk (e.g. strong family history) should consider avoiding alcohol all together.

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Too much of a good thing

For men, the magic number for cardiovascular health is one to two drinks per day; for women, it is one. And, of course, pregnant women should not drink at all.

We cannot ignore the risks of excessive alcohol. Moderate drinking with meals, as practiced in many Mediterranean countries, is the best strategy for optimizing the protective effects of alcohol. People who drink more than this increase their risks of a whole host of serious illnesses, ranging from cancer to liver disease to trauma from automobile accidents.

Our prescription

Available evidence suggests that moderate alcohol consumption can be part of a heart-healthy lifestyle. That said, we don’t recommend that teetotalers begin drinking for heart health. If you drink alcohol, drink in moderation. This means no more than two drinks per day for men and no more than one drink per day for women. A glass of wine (or beer or spirits) a day can be good for your heart.