Holidays, Alcohol and Heart Failure

Shannon Donovan • 20 December 2023

As we go into holiday celebrations and bringing in the New Year, I want to share information about Alcohol and Heart Failure.  Most heart failure patients are advised to abstain from alcohol, but in reality, we know that celebrations often include alcohol and family holiday celebrations and ringing in the New Year are some of those occasions.  As we move into our celebrations, I want to give an explanation of why minimizing and avoiding alcohol is best for people living with heart failure. 

Heart Failure in essence is a decrease in the contractility (strength) of the heart muscle.  The word inotrope is the medical term that is used to describe contractility.   There are various substances that increase contractility (positive inotropes) and substances that decrease contractility (negative inotropes).  An example of a positive inotropic substance, that strengthens the force of cardiac contraction, is digoxin.  Many heart failure patients are given digoxin as a medication because it is proven to improve symptoms and help keep you out of the hospital.     

On the contrary a substance that is known to decrease contractility of the heart muscle is Alcohol.  Alcohol is a substance that weakens the force of heart muscle contraction and has a negative inotropic effect on the heart muscle.  When someone already has a weak heart and poor heart muscle contractility( heart failure), drinking alcohol (and especially drinking too much) can weaken the heart muscle even further.  This can result in worsening heart failure symptoms, leading to hospitalization and a decline in overall progress.  Chronic alcohol intake is one of the reasons people can develop heart failure in the first place.  If you have a history of heart failure due to alcohol, then you will want to steer clear of any alcohol intake.  

Of course, everyone should discuss drinking alcohol with their heart failure provider, but I would suggest if you plan to drink alcohol, stick to drinking only one alcoholic beverage.  Here is an example of what “one” drink would be: 

Examples of “One” Standard Alcoholic Drink
Examples of “one” standard alcoholic beverage

As an alternative to an alcoholic beverage try club soda with a splash of fruit juice as a refreshing and sparkling alternative to an alcoholic beverage.

You can also add sparkling water or soda water to wine to make the wine beverage last a little longer.  This also cuts calories! And don't forget to include your beverage choices into your overall daily count of fluid intake.  A typical 24 hour fluid restriction for a heart failure patient is around 64 ounces a day.   

Wishing you all a happy, healthy and safe Holiday Season and New Year!


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