Cardiac Responses to Alcohol: A Review of Mechanisms and Clinical Implications.

Alcohol has been appreciated by civilizations for thousands of years. Nonetheless, alcohol has recently been linked to serious cardiovascular diseases. Therefore, this review summarizes the effects of alcohol on the heart based on the most current literature available. This review covers the effects of alcohol on blood pressure (BP), heart rate (HR), autonomic dysfunction, coronary artery disease (CAD), cardiomyopathy, and cardiac arrhythmias. Evidence supports the harmful effects of both acute (binge) and chronic heavy alcohol consumption on BP, HR, autonomic dysfunction, and the risk of CAD, cardiomyopathy, and various arrhythmias. Some studies suggest that mild to moderate drinking may reduce the risk of CAD and arrhythmias, consistent with a potential J-shaped relationship. However, other evidence contradicts this, thereby indicating that alcohol use may increase the risk of developing hypertension, CAD, and atrial fibrillation. At the time of this review, evidence supports the harmful effects of acute and chronic heavy alcohol consumption on the heart. Findings are mixed for mild to moderate drinking and may be influenced by confounding factors, underscoring the need for further research. Given the inconclusive benefits, the authors recommend that no level of alcohol consumption be promoted as beneficial for cardiac health.