What Happens to Your Heart When You Drink Wine, According to Experts

Conflicting messaging about wine can leave you wondering whether that nightly glass is helping or hurting your health. Red wine often gets attention for its antioxidants like polyphenols, which may support heart health. But newer research shows that alcohol—even in small amounts—carries risks. In fact, the benefits often linked to wine may be more about healthy lifestyle habits like eating well, staying active and managing stress. 

Preventive cardiology dietitian Michelle Routhenstein, M.S., RD, CDCES, CDN, adds to this sentiment, “At the end of the day, it’s your everyday habits, nutritious food, movement, rest and stress management practices that truly support your heart, not the wine in your glass.”

So what actually happens to your heart when you drink wine? We asked experts to explain the short- and long-term effects so you can make an informed choice about whether to pour that glass of wine. 

Wine’s Short-Term Effects on Heart Health

The short-term effects of wine on your heart are mixed, and experts agree no level of alcohol is risk-free.

• Blood pressure fluctuations: One to two glasses of wine may not affect your blood pressure. However, three or more glasses decrease blood pressure for up to 12 hours after drinking, before raising blood pressure for the following 12 to 24 hours. Blood pressure fluctuations may not be noticeable, but can still put added strain on the heart, adds Routhenstein. 
• Holiday heart syndrome: Overindulging in alcohol, caffeine or salty foods—often during vacations or holidays—can trigger what’s known as “holiday heart syndrome” or sudden irregular heartbeats. Anyone can experience holiday heart syndrome, even if you only drink occasionally, notes Kiran Campbell, RD.
• Potential reductions in LDL cholesterol: Campbell highlights research that red wine may potentially reduce LDL cholesterol, with minimal effects on other aspects of the lipid profile. But experts caution against using this as a reason to drink.
• Improvements in antioxidant status: Red wine contains resveratrol, a potent polyphenol with potential health benefits that may include slowing aging and improving skin health. When you drink a glass of red wine, the concentration of polyphenols in your bloodstream increases. Higher antioxidant levels may contribute to lower levels of cell damage.

What Drinking Wine Does to Your Heart in the Long Run

When it comes to your long-term heart health, research suggests alcohol does more harm than good.

1. Increases Triglycerides

Alcohol raises triglyceride levels, contributing to plaque buildup in the arteries and elevating the risk for heart disease and strokes, Routhenstein explains. Triglycerides are a type of fat in the blood that comes from foods and consuming excessive calories.

According to one study, moderate drinking was associated with a 25% higher risk of elevated triglyceride levels. Heavier drinking further raises the risk of high triglycerides. 

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2. Raises the Risk of Alcohol-Induced Cardiomyopathy

“Chronic overconsumption may lead to alcohol-induced cardiomyopathy (AIC), a condition where the heart muscle becomes weakened and less efficient at pumping blood,” explains Routhenstein. “This occurs because ethanol, the type of alcohol in wine, has a toxic effect on heart muscle cells.”

Ethanol promotes oxidative stress in the heart muscle, contributing to cell death, muscle breakdown and impaired heart muscle contractions. Acetaldehyde—a product of ethanol breakdown in the body—also damages cells and prevents the heart muscle from contracting properly to move blood through the body.

More recently, researchers have discovered a link between genetic factors and AIC. Drinking alcohol may “turn on” genetic variants associated with AIC.

3. Contributes to Nutritional Deficiencies

Alcohol provides calories but lacks vitamins, minerals and other nutrients essential to health. A glass of wine here and there may have a limited effect on your overall food and calorie intake. But more consistent heavy alcohol intake can lead to nutritional deficiencies. 

In particular, chronic alcohol consumption can contribute to thiamine deficiency. Thiamine is essential for healthy heart function, notes Routhenstein. A higher thiamine dietary intake is linked to a reduced risk of hypertension, heart failure and cardiovascular mortality.

4. Atrial Fibrillation

Atrial fibrillation (A-fib) is an irregular heartbeat, often a very rapid heart rhythm. Atrial fibrillation increases the risk of serious medical conditions, such as heart attack and stroke. Alcohol interferes with the heart’s electrical signals, which can contribute to atrial fibrillation and weaken how the heart pumps, explains Campbell. While data conflicts on one glass of alcohol’s effects on A-fib, people who abstain from alcohol appear to have the lowest risk of developing A-fib.

5. Increases Blood Pressure

“Alcohol stimulates the sympathetic nervous system, your body’s ‘fight-or-flight’ response, which can raise blood pressure and heart rate,” says Routhenstein. “Research shows that even 12 grams of alcohol per day, which is less than one standard drink, can raise systolic blood pressure.”

6. Increases Inflammation

The relationship between wine and inflammation is complex, with previous research suggesting that small amounts of red wine may reduce inflammation and support heart health. But this research may now be outdated. 

According to Christopher Ader, M.S.N., FNP-BC, recent research indicates that alcohol is inflammatory. Wine contains alcohol and sugar, known inflammatory agents. The inflammatory effects of alcohol and sugar contribute to the buildup of plaque in artery walls (atherosclerosis), which increases the risk of a heart attack or stroke. Atherosclerosis is associated with inflammation within vessel walls, explains Ader. 

Drinking Wine with High Blood Pressure

If you have high blood pressure, even moderate drinking can make things worse. Research shows that just one 5-ounce glass of wine per day is linked to an 11% higher average risk of developing hypertension compared to not drinking at all.

The American College of Cardiology and the American Heart Association recommend cutting back or eliminating alcohol entirely to help manage blood pressure.

Drinking Wine on Blood Pressure Medication

Drinking wine while on blood pressure medication can cause adverse effects and make it harder for the drugs to work. “The alcohol in wine can alter metabolism, absorption and the intended effects of the medication, potentially causing dizziness, fainting, irregular heartbeat or other critical health issues,” explains Erin Wells, M.S., RD, LDN. A study done on men found that those who drink alcohol in general may require more medication to achieve the same effect.

How Much Wine Is OK?

“It is difficult to determine what amount of wine would be considered safe for cardiac health,” explains Ader. “There is likely no risk with occasional drinking, but allowing two drinks daily as previously thought to be healthy [for men] is likely outdated information.”

Current guidelines from the American Heart Association suggest that if you do drink, keep it to less than one 5-ounce glass of wine per day for females and two for males. And if you don’t already drink, there’s no reason to start for health benefits.

Our Expert Take

Many unknowns remain for the effects of moderate wine drinking on heart health. If you regularly drink more than the recommended one glass of wine for females and two glasses for males per day, consider reducing your intake. Heavy drinking negatively affects heart health, increasing your risk of cardiovascular disease. 

While the occasional glass of wine may provide some benefits, there’s no need to start drinking wine if you don’t already. As Routhenstein explains, “If you’re managing high blood pressure, experiencing palpitations, or noticing poor sleep after drinking, it may be best to avoid alcohol altogether.”