Alcohol affects the heart in more ways than most people realise — it can raise blood pressure, trigger atrial fibrillation, increase stroke risk, disturb sleep, drive weight gain, push up triglycerides, and with heavy long-term use, weaken the heart muscle itself.
For years the message was that a daily glass of wine was good for the heart. The evidence has moved on. This page sets out what alcohol actually does to the cardiovascular system, what counts as a standard drink in Australia, how much is too much, and who should be especially careful.
Is Alcohol Good for the Heart?
Short answer: there is no good reason to drink alcohol for your heart.
Older studies did suggest light-to-moderate drinkers had less heart disease than non-drinkers. The problem is that most were observational and heavily confounded. The “non-drinker” group often included people who had stopped drinking because they were already unwell (the “sick-quitter” effect), and regular moderate drinkers tend to be wealthier, more active and healthier in other ways. When newer methods correct for this — including genetic (Mendelian randomisation) studies and pooled individual-patient data — the apparent benefit largely disappears.
Current evidence does not support drinking alcohol for heart protection. If there is any cardiovascular benefit from low-level intake, it is small, uncertain, and outweighed for many people by risks such as AF, high blood pressure, stroke, cancer and liver disease.
The old idea that red wine is protective (the “French Paradox”) is best treated as a myth. Any beneficial compounds in wine are present in far higher and safer amounts in fruit, vegetables and tea — without the alcohol.
How Alcohol Affects Blood Pressure, AF and Stroke Risk
It pushes blood pressure up
The more you drink, the higher it climbs — and cutting back lowers it again, often within weeks.
It can trigger AF
Alcohol is one of the most consistent triggers for atrial fibrillation. Even one heavy session can set off an episode — “holiday heart”.
It raises stroke risk
Higher intake increases the risk of both clot-related and bleeding strokes, partly via blood pressure and AF.
It worsens sleep and weight
It fragments sleep and worsens snoring and sleep apnoea, and is energy-dense — promoting weight gain around the middle.
It raises triglycerides
In susceptible people even modest alcohol raises triglycerides, a recognised cardiovascular risk factor.
It can weaken the heart muscle
Years of heavy drinking can weaken and enlarge the heart — alcoholic cardiomyopathy and heart failure. More below.
What Is a Standard Drink in Australia?
In Australia, one standard drink contains 10 grams of pure alcohol — the same whether it’s beer, wine or spirits. The catch is that almost nothing you’re actually served equals exactly one. A schooner, a restaurant glass of wine and a generous home pour are all well over one, which is why people routinely drink more than they think.
Ten grams is ten grams — the same in beer, wine or spirits. The catch: almost nothing you’re actually poured equals just one.
Use the calculator below to add up your own drinking — by the day, week, month and year — then read on for how much is too much.
Standard drinks calculator: how much are you really drinking?
Add the drinks you have in a typical week. The calculator works out the grams of pure alcohol and standard drinks — and how that adds up over a month and a year.
In a typical week, I drink
Educational estimate only, based on average alcohol content — actual strength varies, so check the label. This is not a measure of intoxication or blood-alcohol level. The Australian guideline is an upper limit, not a target: for your heart, less is better, and if you don’t drink there’s no reason to start.
How Much Alcohol Is Too Much?
The Australian (NHMRC) guidelines for healthy adults are no more than 10 standard drinks per week, and no more than 4 standard drinks on any one day.
Two caveats matter. These are an upper limit to keep risk low — not a target, and not a recommendation to drink that much. The Heart Foundation is explicit that lower is better, and for many people none is the safest option; staying within the guidelines keeps risk low but does not remove it. And if you currently don’t drink, there’s no health reason to start.
The daily limit matters as much as the weekly number: heavy single sessions (binge drinking) carry their own risks — AF, injury and sudden cardiac events — even in people otherwise within their weekly total.
A useful heart-health target isn’t “10 a week” — it’s “less than I currently drink,” especially if you have AF, high blood pressure, high triglycerides or poor sleep.
Beyond the heart, alcohol is also linked to several cancers and to liver disease. This is one reason health authorities increasingly advise that the lowest-risk level is the lowest intake.
Who Should Cut Back or Avoid Alcohol?
Some people should drink well below the general limits, or not at all:
- Atrial fibrillation & arrhythmiasA direct trigger; cutting back reduces episodes. More on AF.
- High blood pressureAlcohol works against your treatment.
- Heart failure or cardiomyopathyAlcohol further weakens the heart muscle.
- High triglyceridesAlcohol raises them. How to lower triglycerides.
- Liver diseaseThe heart and liver effects compound.
- Pregnancy or breastfeedingNo amount is considered safe in pregnancy, breastfeeding or when trying to conceive.
- Alcohol dependence historyA personal or strong family history of dependence.
- Interacting medicationsBlood thinners (e.g. warfarin), blood-pressure and heart medicines, some diabetes drugs and sedatives — check with your doctor or pharmacist.
How to Cut Back
Small changes add up:
- Set several alcohol-free days each week.
- Use smaller glasses and measure spirits rather than free-pouring.
- Alternate each alcoholic drink with water.
- Spread drinks out rather than saving them up for one heavy session.
- Track your standard drinks — the label tells you how many.
- Don’t use alcohol as a sleep aid; it worsens sleep quality.
If you drink heavily every day, don’t stop abruptly on your own — sudden withdrawal can be dangerous. Ask your GP about the safest way to cut down.
When to Seek Help
If alcohol is hard to control — you can’t cut down, you keep drinking despite the problems it’s causing, or you get withdrawal symptoms (shakes, sweating, anxiety) when you stop — that’s worth acting on, and help is available.
- Your GP — the best first step for assessment and referral.
- National Alcohol and Other Drug Hotline: 1800 250 015 (free, 24/7)
- Alcohol and Drug Foundation: 1300 858 584
- Alcoholics Anonymous Australia: 1300 222 222
Alcoholic Cardiomyopathy
Long-term heavy drinking can weaken and enlarge the heart muscle — a condition called alcoholic cardiomyopathy that can lead to heart failure. Encouragingly, it can improve, sometimes dramatically, when a person stops drinking early enough.
Read more: Alcoholic cardiomyopathy — a real case and recovery →
Frequently Asked Questions
Is red wine good for your heart?
Not in a way that justifies drinking it for health. Older studies suggested a benefit, but newer evidence indicates this was largely confounding. If you enjoy wine, think of it as alcohol, not medicine.
How many standard drinks are in a bottle of wine?
About 8 standard drinks in a 750 mL bottle of red — close to a week’s entire low-risk limit in a single bottle.
I already have heart disease — do I have to stop completely?
Not necessarily, but the lowest risk is at the lowest intake, and for conditions like AF, heart failure or high blood pressure, cutting right back or stopping is the safest choice. Discuss your situation with your cardiologist.
Does alcohol cause atrial fibrillation?
It is one of the most consistent triggers. Risk rises with intake, a single heavy session can provoke an episode, and reducing alcohol lowers the chance of recurrence.
References & Further Reading
Clinical references
- National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. NHMRC, 2020.
- National Heart Foundation of Australia. Alcohol and heart health.
- Piano MR, et al. Alcohol use and cardiovascular disease: an American Heart Association scientific statement. Circulation. 2025.
- Voskoboinik A, et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med. 2020;382:20–28.
- Holmes MV, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis. BMJ. 2014;349:g4164.
Further reading for patients
- Heart Foundation (Australia) — Alcohol and your heart.
- Heartcare Sydney — How to prevent a heart attack.
Concerned about alcohol and your heart?
Dr Reza Moazzeni is a consultant cardiologist in Westmead and St Leonards. If alcohol may be affecting your blood pressure, heart rhythm or heart muscle, a review can help. A GP referral is required for all consultations.
Book an appointment