Vascular Effects of Alcohol

If you’ve ever experienced your heart racing and your face getting hot after drinking alcohol, you’re not alone. The vascular system is incredibly complex, and alcohol has complex interactions with it. So take a deep breath and keep that blood pressure down, and we’ll learn how alcohol affects our vascular system — and what we can do to stay safe and keep our heart and veins healthy for years to come.

Overview of the Vascular System

If you’ve forgotten what you learned in middle school biology about the vascular system, don’t worry, we’ll go through the basics. The vascular system, also known as the cardiovascular system, is part of the circulatory system and is made up primarily of the heart and blood vessels. It is responsible for bringing oxygenated blood to all parts of our body.

The job of transporting blood sounds pretty important, right? Well, it is! That’s why it’s important to keep it healthy.

We may have heard of those “heart-healthy” diets and tips to stay away from high cholesterol or processed foods, but what about alcohol? Does alcohol affect the vascular system? And more specifically, does alcohol cause vasodilation?

How Does Alcohol Affect the Cardiovascular System?

Alcohol has complex interactions with the cardiovascular system, which at times may seem to contradict each other. Let’s dive deeper into both the short- and long-term effects of alcohol on the vascular system and learn just how complex it is.

Immediate Effects of Alcohol on the Vascular System

Let’s start off with what happens to our body while drinking or a few hours after drinking. Alcohol is a known vasodilator, which means it causes vasodilation, or the widening of the blood vessels. This is what gives us that warm feeling when we begin sipping alcohol — it’s our blood vessels widening. This also leads to lower blood pressure since the heart doesn’t have to pump so hard. 

This effect is only temporary, though, and our blood pressure rises over time with chronic alcohol use. So you may be wondering, “Is alcohol a vasodilator or a vasoconstrictor?” Well, the answer is, it’s both. To understand that, we need to look at another player: nitric oxide.

The Role of Nitric Oxide

Nitric oxide is found in the lining of the blood vessels and is the actual chemical responsible for vasodilation when it gets released. Low amounts of alcohol release nitric oxide, resulting in vasodilation. High amounts, however, damage the lining of the blood vessels and decrease the amount of nitric oxide available to be absorbed. This causes “vasoconstriction,” or a narrowing of the blood vessels, which results in increased blood pressure. When we binge drink, our blood pressure increases because we’ve consumed a very large amount of alcohol in a short time, so the vasoconstriction process is fast-forwarded a little (For more information about how alcohol affects the blood, check out our blog “What Does Alcohol Do to Your Blood?”).

Long-Term Effects of Alcohol on the Vascular System

Nitric oxide is affected by long-term alcohol use, too. Similar to high doses of alcohol, chronic exposure to alcohol damages the lining of the blood vessels (a condition known as “endothelial dysfunction,” or damage to the endothelial cells that line the blood vessels), reduces the availability of nitric oxide, and impairs its production, making it harder for the blood vessels to widen, creating adverse effects. 

• Increased blood pressure over time. Long-term vasoconstriction can lead to high blood pressure in chronic drinkers (or hypertension). High blood pressure can lead to a whole lot of problems, including stroke, heart attack, kidney problems, and aneurysms.
• Chronic chest pain. This occurs as a symptom of endothelial dysfunction; it happens when the arteries are closing more than they should be.

These may sound uncomfortable, but there are more serious effects that could occur from alcohol use.

• Risk of blood clots. The constriction of the blood vessels from the decrease of nitric oxide in the blood is bad enough when talking about blood clots. But alcohol also impairs certain proteins that prevent blood clotting, giving us a recipe for a blood clot.
• Impairment of blood cell development. Chronic excessive drinkers can develop deficiencies in certain vitamins that produce red blood cells. This condition can result in fewer healthy red blood cells in the body and cause anemia. The good news is, this is reversible if we quit drinking alcohol.
• Increased risk of heart disease and heart attack. While alcohol wouldn’t be the direct cause of a heart attack, it raises our risk of one. Among deaths from excessive alcohol use in the United States from 2016 to 2021, death rates from heart disease were ranked the most prevalent, particularly in females. The reasons are the hormonal and physical differences between males and females that make women more susceptible to heart disease and heart attacks.
• Risk of developing atherosclerosis. When we don’t have enough nitric oxide in our blood, our arteries can become inflamed and plaque build up. As a result, our arteries become thicker, and less blood can move through them.

With all these nasty side effects of long-term alcohol use, you can understand why chronic binge drinking in particular is bad news for our blood vessels.

Following Your Heart

We’ve talked about the vascular system, but what about the heart? Since the heart is the head honcho of the vascular system, let’s take a closer look at how alcohol affects it.

Immediate Effects of Alcohol on the Heart

We can feel some effects within a few hours of drinking.

• Hormonal imbalance. Alcohol affects all of our hormones, but immediate alcohol use also increases the production of cortisol, which is our stress hormone. This not only throws our hormones off balance but also increases our heart rate. 
• Rapid and irregular heartbeat. The release of cortisol is responsible for the rapid heartbeats we may feel after drinking. Alcohol use eventually causes the heart to beat irregularly as well, which puts uuneven stress on the heart.
• Heartburn. If you’ve ever had heartburn, you know it’s no joke. Alcohol relaxes the lower esophageal sphincter (which connects the throat to the stomach), and it can cause acid to leak into the esophagus, resulting in that dreaded ring of fire in the chest.

Long-Term Effects of Alcohol on the Heart

While the immediate effects of alcohol on the heart may seem fixable, and they are, long-term alcohol use affects the heart and results in more complications:

• Change in cardiac structure. Not only does alcohol affect the functioning of the heart, it can affect the structure. One study looked at the relationship between alcohol and the structure of the heart and found that, in older people, a history of drinking resulted in differences in cardiac structure and function compared to non-drinkers, again with women being more susceptible to these negative effects.
• Cardiomyopathy. Cardiomyopathy is when the heart muscle becomes weaker or functions irregularly. Among the causes of cardiomyopathy, alcoholic cardiomyopathy is one of the main ones.
• Peripheral artery disease (PAD) and peripheral vascular disease (PVD). Peripheral artery disease is the narrowing of the arteries in the extremities, particularly the legs. Excessive alcohol consumption increases the risk of developing it, which in turn can increase the risk of stroke or other complications. This is not to be confused with peripheral vascular disease, which is the narrowing of any old blood vessel outside the heart or the brain. Since chronic alcohol use causes a drop in nitric oxide leading to vasoconstriction, we are more susceptible to both these conditions.

The Indirect Association

It’s worth mentioning that it’s not just alcohol alone that leads to vascular problems. Heavy drinking or even occasional binge drinking indirectly affects our life in all ways. (When was the last time you skipped your workout the day after a night of drinking?) Add to the alcohol our decreased energy, lack of sleep, and overindulgence in salty hangover foods post-drinking, and we’ve managed to combine a bunch of bad things that together have a compounding negative effect on our heart and vascular system.

Heart-Healthy Tips

Don’t get your heart broken over these effects. The good news is, there are many things you can do to keep your heart healthy and rebuild cardiovascular strength if you’re affected by alcohol-induced vascular damage.

• Quit or cut back on alcohol. Reducing our alcohol intake can work wonders for the health and longevity of our heart by helping its rhythm stay consistent and keeping those good old endothelial cells in shape.
• Maintain a healthy diet. Garbage in, garbage out. Nourishing our heart with vitamin-rich foods such as vegetables helps reduce the risk of plaque buildup in the arteries, making our heart’s job easier. Healthy fats such as legumes and foods rich in omega-3 fatty acids are also beneficial for our heart.
• Get active. Not only does being sedentary mean we’re not working our heart, but a chronic sedentary lifestyle increases our risk of blood clots.
• Quit smoking. Smoking is terrible for our heart health. Not only that, many people tend to drink and smoke at the same time. A study found that 67% of smokers have reported smoking while drinking, so avoiding alcohol may eliminate smoking automatically.
• Decrease stress. Stress also raises blood pressure and contributes to negative health problems besides just heart problems. Instead of having a drink at the end of a long, tough day at work, try meditating for stress relief. (To learn some meditation techniques, check out our post “The Best Meditations for Stress Relief.”)
• Have a heart-to-heart with your doctor. It’s important to get your heart checked out by a doctor if you have heart problems (or any other health problems for that matter), and listen to their advice and adhere to restrictions they set for you.

Getting to the Heart of It

The vascular system has a pretty big job with all that blood to pump and all those organs to oxygenate, and keeping it healthy is hard enough. With all the demands and responsibilities of life and work, we may not realize how much stress we put on our body on a daily basis or how hard the vascular system is working to keep things going. Keeping our vascular system healthy will help make sure we’re around for a long time, and quitting or cutting back on alcohol is a great start to a healthier lifestyle. So listen to your heart, literally, and give it the love it deserves so it can keep pumping you through life!