Alcohol & Smoking

Alcohol & Smoking

Alcohol and smoking will worsen the condition of heart failure, so it is essential that people with heart
failure reduce their alcohol intake and quit smoking.

How Much Alcohol Is Too Much?

Whether or not moderate drinking is good for your heart is open to debate. However, for most people, it doesn’t appear to be harmful to the heart — but the key word is “moderate.”

Moderate drinking is defined as an average of one drink per day for women and one or two for men. A drink might be less than you think: 12 ounces of beer, 4 ounces of wine or 1.5 ounces of 80-proof spirits. Some people should avoid even that much and not drink at all if they have certain heart rhythm abnormalities or have heart failure.

Heavy drinking, on the other hand, is linked to a number of poor health outcomes, including heart conditions. Excessive alcohol intake can lead to high blood pressure, heart failure or stroke. Excessive drinking can also contribute to cardiomyopathy, a disorder that affects the heart muscle.        

Alcohol & Cardiovascular Disease

Alcohol consumption increases an individual's risk of cardiovascular disease. The heart and blood vessels form part of the cardiovascular system. Blood is pumped around the body by the heart, via these blood vessels through arteries, capillaries and veins. The blood delivers nutrients and other materials to all parts of the body, including alcohol, which is absorbed directly into the blood stream mainly via the stomach and small intestine.

The cardiovascular system is affected by alcohol. At the time of drinking, alcohol can cause a temporary increase in heart rate and blood pressure. In the long-term, drinking above the recommended guidelines can lead to on-going increased heart rate, high blood pressure, weakened heart muscle and irregular heartbeat; all of which can increase the risk of alcohol-caused heart attack and stroke. 

 Increased Heart Rate

Heart rate is the number of times the heartbeats per minute. Alcohol can cause variability in the way the heart beats – the time between heart beats. Studies have found that regular heavy drinking can cause episodes of tachycardia (increased heart rate due to problems in the electrical signals that produce a heartbeat). Complications due to regular episodes of tachycardia, do vary depending on their frequency, length and severity, but it can cause blood clots that can lead to a heart attack or stroke.

Increased Blood Pressure

Blood pressure is a measure of the force blood places against blood vessel walls. High blood pressure is when the blood is pumping with more force than normal through the arteries. Drinking alcohol on a single occasion can see a temporary increase in blood pressure, and regularly drinking alcohol above the national recommended guidelines can cause alcohol-caused hypertension (high blood pressure). It is likely there are multiple mechanisms which cause alcohol to raise blood pressure, and studies have shown that a reduction in alcohol intake can lower blood pressure. High blood pressure can cause hardening and thickening of the arteries and is a risk factor for heart attack and stroke. Studies have found the consumption of more than two standard drinks a day can see an immediate increase in blood pressure and increases the risk of developing hypertension.



  Weakened Heart Muscle

The heart is critical in getting oxygen and nutrients around the body and achieves this by generating the pressure for blood to circulate around the body, ensuring blood only flows in one direction. The frequency and force of the heart’s contractions adjust depending on the needs of the body. The anatomy of the heart is complex, but the heart’s ability to contract is due to the muscle layer within the heart wall. Heart muscle is called myocardium, and damaged heart muscle is called cardiomyopathy. Heavy alcohol consumption can lead to cardiomyopathy.

Dilated cardiomyopathy results in weakened heart muscle that causes the four heart chambers to enlarge, resulting in weaker contractions (this makes it harder for the blood to circulate around the body). Cardiomyopathy can eventually lead to congestive heart failure, which is when the heart doesn’t pump enough for the needs of the body.

Irregular Heartbeat

A change in heart rhythm is called an arrhythmia. Arrhythmias can occur because of changes to the heart's electrical system, which can be caused by blocked signals, abnormal pathways, irritable heart cells, medicines and stimulants. Some of the common arrhythmias include the heart beating too slow (bradycardia), or too fast (tachycardia). Arrhythmias can cause cardiac arrest and stroke.

The occurrence of acute cardiac rhythm disturbances (atrial fibrillation is the most common) have been found to be induced by alcohol. Sometimes referred to as ‘holiday heart’ these disturbances were found to be more frequent after weekends or holidays like Christmas or New Years which are known to have higher alcohol consumption.

Atrial fibrillation

Atrial fibrillation is one type of arrhythmia and causes the upper chambers of the heart (the atriums) to quiver rather than beat normally. Alcohol causes atrial fibrillation through multiple mechanisms and can be seen both acutely (after one off drinking occasion) and from the cumulative effects of alcohol on the heart muscle. This means blood does not circulate as efficiently as it should. This can result in blood, which hasn’t left the atrium, pool and clot. If the blood that has clotted within the atrium breaks off and is within the blood stream it can lodge in an artery within the brain causing an ischemic stroke.

What Cardiovascular Diseases Can Alcohol Cause?

Heart attack

Your heart muscle needs oxygen so it can keep pumping. A heart attack is when an artery supplying oxygen to the heart muscle is reduced or cut off completely, preventing the heart muscle receiving oxygen. The blood flow to the heart can be blocked due to a gradual build up of plaque, fat and cholesterol that cause a narrowing of the coronary arteries. Alcohol consumption can raise the levels of fat in the blood. People with high triglycerides often have high levels of bad cholesterol and low levels of good cholesterol. High levels of bad cholesterol can clog arteries and if a piece of plaque breaks off, a clot forms and a heart attack can result.


Alcohol consumption can increase the risk of two types of strokes occurring. Both result in a disrupted blood flow to brain tissue and can result in a loss of motor (movement) and sensory (touch, temperature sensations) functions. A stroke can also damage other systems in the body including the skeletal, muscular, respiratory, digestive and urinary systems.


Ischemic stroke

This is when an artery supplying blood to the brain tissue is blocked. This blockage can result from a clot that has formed in the artery or from a foreign body (such as a fat globule) that has broken off that becomes lodged in the artery, blocking it.





Haemorrhagic stroke

This results from an artery supplying brain tissue, tearing and bleeding. Alcohol increases the risk of haemorrhagic stroke because it can cause high blood pressure. High blood pressure can create weak points on artery walls, including those in the brain, increasing the chance of them bleeding due to the force of high pressure.


Every cigarette contains more than 4,000 harmful chemicals including nicotine which triggers the body to release adrenaline. This narrows the blood vessels and forces the heart to beat harder.

Smoking damages the blood vessels, reduces the amount of oxygen in the blood and makes the heartbeat faster. All these can make the heart condition worse. Smoking can lead to heart disease, stroke, cancer, lung diseases and stomach ulcers.

Smoking is a major cause of cardiovascular disease (CVD) and is the single largest cause of death in the United States, killing more than 800,000 people a year. More than 16 million Americans have heart disease. Almost 8 million have had a heart attack and 7 million have had a stroke. Even people who smoke fewer than five cigarettes a day may show signs of early CVD. The risk of CVD increases with the number of cigarettes smoked per day, and when smoking continues for many years. Smoking cigarettes with lower levels of tar or nicotine does not reduce the risk for cardiovascular disease. Exposure to second-hand smoke causes heart disease in non-smokers. More than 33,000 non-smokers die every year in the United States from coronary heart disease caused by exposure to second-hand smoke. Exposure to second-hand smoke can also cause heart attacks and strokes in non-smokers.

Passive smokers (people who breathe in other people’s smoke) suffer similar health risks as smokers. If you are a smoker with heart failure, it is important to quit smoking.

How Smoking Harms The Cardiovascular System

Chemicals in cigarette smoke cause the cells that line blood vessels to become swollen and inflamed. This can narrow the blood vessels and can lead to many cardiovascular conditions.


In this condition, arteries narrow and become less flexible, occurs when fat, cholesterol, and other substances in the blood form plaque that builds up in the walls of arteries. The opening inside the arteries narrows as plaque builds up, and blood can no longer flow properly to various parts of the body. Smoking increases the formation of plaque in blood vessels.

Coronary Heart Disease

This occurs when arteries that carry blood to the heart muscle are narrowed by plaque or blocked by clots. Chemicals in cigarette smoke cause the blood to thicken and form clots inside veins and arteries. Blockage from a clot can lead to a heart attack and sudden death.


Stroke is a loss of brain function caused when blood flow within the brain is interrupted. Strokes can cause permanent brain damage and death. Smoking increases the risk for strokes. Deaths from strokes are more likely among smokers than among former smokers or people who have never smoked.

Peripheral Arterial Disease

(PAD) and Peripheral Vascular Disease occur when blood vessels become narrower and the flow of blood to arms, legs, hands and feet is reduced. Cells and tissue are deprived of needed oxygen when blood flow is reduced. In extreme cases, an infected limb must be removed. Smoking is the most common preventable cause of PAD.

Abdominal Aortic Aneurysm

This condition occurs when there is a bulge or weakened area that occurs in the portion of the aorta that is in the abdomen. The aorta is the main artery that carries oxygen-rich blood throughout the body. Smoking is a known cause of early damage to the abdominal aorta, which can lead to an aneurysm. A ruptured abdominal aortic aneurysm is life-threatening; almost all deaths from abdominal aortic aneurysms are caused by smoking. Women smokers have a higher risk of dying from an aortic aneurysm than men who smoke. Autopsies have shown early narrowing of the abdominal aorta in young adults who smoked as adolescents.

Is It Too Late to Quit Smoking?

Smoking damages the heart and blood vessels very quickly, but the damage is repaired quickly for most smokers who stop smoking. Even long-time smokers can see rapid health improvements when they quit. Within a year, heart attack risk drops dramatically. Within five years, most smokers cut their risk of stroke to nearly that of a non-smoker. Even a few cigarettes now and then damage the heart, so the only proven strategy to keep your heart safe from the effects of smoking is to quit.

Even though we don’t know exactly which smokers will develop CVD from smoking, the best thing all smokers can do for their hearts is to quit. Smokers who quit start to improve their heart health and reduce their risk for CVD immediately. Within a year, the risk of heart attack drops dramatically, and even people who have already had a heart attack can cut their risk of having another if they quit smoking. Within five years of quitting, smokers lower their risk of stroke to about that of a person who has never smoked.