Some doctors will advise people with congestive heart failure (CHF) to avoid alcohol, particularly in large quantities. Although the compounds in red wine may be beneficial for heart health, the risks for someone with heart failure may outweigh these benefits.

Adopting a healthy diet and lifestyle are key to avoiding heart conditions and the risk of cardiovascular diseases.

This article explains the link between alcohol consumption and CHF and looks at the evidence about the risks of drinking alcohol.

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Systolic CHF is a condition in which the heart does not pump blood around the body as efficiently as it should, causing blood to become backed up or congested within the heart.

This serious condition, which doctors sometimes refer to simply as heart failure, can result in an enlarged heart, shortness of breath, and palpitations. It can also lead to kidney failure.

About 6 millionadults in the United States have heart failure. According to Johns Hopkins Medicine, it is also the most common cause of hospitalization in people over the age of 65.

Research indicates that heavy drinking can damage the structure and function of the heart before symptoms occur.

The American Heart Association (AHA) advises that drinking every day can lead to serious cardiovascular disease risk factors, including high blood pressure, obesity, hypertriglyceridemia, and stroke.

People who misuse alcohol over a long period can develop alcoholic cardiomyopathy. This is a type of heart failure in which alcohol toxicity weakens the heart muscle.

Although there is little research into the effects of moderate drinking on the risk of CHF, Johns Hopkins cardiologist Steven Jones, M.D., suggests that preventing other heart problems by adopting a healthy lifestyle is key.

Doctors consider being mindful of alcohol intake, excess calories, and adequate activity part of a healthy lifestyle.

A review of evidence in the Nursing Times concluded that there is very little research on the effects of alcohol on people with heart failure.

The review suggests that although scientists do not yet fully understand the way that alcohol causes heart failure, alcohol-induced hypertension and the release of stress hormones called catecholamines may exacerbate the negative effects on the heart. Alcohol may also have direct toxic effects on the heart.

While the same review advises that people with alcoholic cardiomyopathy should abstain from alcohol completely, it points out that the lack of conclusive studies about alcohol and heart failure limits the advice that health professionals can give regarding alcohol.

There are four stages of heart failure — A, B, C, and D. At stage A, which is pre-heart failure, a doctor may advise someone to avoid drinking alcohol.

Because alcohol is high in calories, it can contribute to weight gain. Avoiding it may help someone maintain a moderate weight and improve their overall heart health.

Some people might have heard that alcoholic drinks such as red wine may be good for the heart and that alcohol may increase beneficial high-density lipoprotein cholesterol.

A 2018 review recommended that a moderate amount of alcohol to consume daily is about 15 grams (g) for women and 30 g for men. The review suggested that antioxidant polyphenols in red wine may benefit heart function and reduce the risk of cardiovascular diseases.

However, the AHA concludes that people should drink alcohol in moderation, if at all, and they should not start drinking for unproven health benefits. Johns Hopkins cardiologist John Williams, MB BCH, advises people with heart failure not to drink at all.

Alcohol may react with medications that people may be taking for CHF, so it is important to discuss alcohol intake with a doctor.

Sometimes a doctor may need to advise a person how much fluid they can drink because the kidneys compensate for diminished blood flow by retaining fluid in the body.

Alcohol can cause dehydration, making the body hold onto fluid. It is important that people discuss their alcohol intake with a doctor, especially if they have symptoms of fluid retention such as bloating or are taking medication.

Harvard Health advises that fluid retention can be life threatening for a person with a history of heart failure.

People can also speak with a doctor about diet and lifestyle strategies that may help them maintain a moderate weight or stop smoking. This may improve their overall health and heart health.

There is little evidence about the effects of alcohol on congestive heart failure, which makes it more challenging for health professionals to advise people with the condition.

People with alcoholic cardiomyopathy and possibly those with other types of cardiomyopathy should abstain from alcohol. Some doctors will advise people with any form of heart failure not to drink alcohol.

There seem to be some health benefits associated with drinking moderate amounts of red wine. Still, experts advise people not to start drinking for this reason, as the benefits are largely unproven.

Alcohol can cause a person to consume extra calories, which can lead to weight gain and may also lead to hypertension, a risk factor for heart disease.

If someone is concerned about their alcohol intake or needs to know if they can drink alcohol with heart failure, they should speak with a doctor, particularly if they are taking medications.