Exploring the complex interplay between alcohol consumption and cardiovascular health: Mechanisms, evidence, and future directions

This review article explores the intricate relationship between alcohol consumption and cardiovascular health, underscoring on both clinical outcomes and underlying pathophysiological mechanisms. It examines the complex dose-response relationships for various cardiovascular disease (CVD) subtypes, including coronary heart disease, stroke, and atrial fibrillation, while categorizing pathophysiological mechanisms into three conceptual areas: primary initiating factors, secondary transmission pathways, and end-organ effects. Although mild-to-moderate alcohol consumption may confer some benefits for cardiovascular health and certain CVD subtypes, growing evidence highlights the importance of lifestyle modifications to reduce alcohol intake, particularly among heavy drinkers. This review provides a comprehensive overview of current knowledge, emphasizes the need for future research with robust methodologies, and advocates for incorporating updated scientific evidence into personalized approaches within international cardiovascular and national guidelines. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.