The relationship between alcohol consumption and cardiovascular diseases continues to generate debate within cardiovascular epidemiology and experimental studies. While early studies suggested protective associations for low-to-moderate drinking and increased risk with higher consumption, advances in epidemiological methodology have raised concerns about confounding and misclassification in previous findings. These developments have fueled a renewed need for rigorous human-focused research to clarify alcohol’s true effects on cardiovascular health, morbidity, and mortality.

This Research Topic aims to deepen the clinical and basic scientific understanding of how ethanol influences cardiovascular and arterial health. Given that cardiovascular diseases remain a leading cause of death globally and that alcohol consumption is a prevalent, modifiable behavior, clarifying its effects could provide crucial insights. This is particularly urgent in light of conflicting evidence about alcohol's biphasic effects on heart health, which is not yet fully understood.

Within this Research Topic, we invite submissions that comprehensively address the epidemiological, behavioral, biomarker, and prevention aspects of alcohol use in relation to cardiovascular diseases and related cardiometabolic outcomes. We are especially interested in epidemiological, clinical, or experimental studies that:

Evaluate behavioral, psychosocial, and lifestyle risk factors associated with alcohol use (e.g., drinking patterns, binge drinking) and their interaction with established cardiovascular risk profiles.
Investigate the association of alcohol consumption with biological risk factors, including blood pressure, dyslipidemia, glucose homeostasis, renal function, and other blood-based biomarkers, using data from human populations.
• Analyze the impact of alcohol use on genomics and other -omics molecular profiles in the context of cardiovascular risk, disease prediction, or prevention.
• Apply state-of-the-art epidemiological methods (e.g., prospective cohort studies, population-based registries, big data analytics) to not only improve the accuracy and generalizability of findings but, importantly, to strengthen causal inference regarding the relationship between alcohol use and cardiovascular outcomes. We particularly encourage studies employing innovative approaches to causal inference, such as genetic epidemiological methods (e.g., Mendelian Randomization), which have been pivotal in challenging assumptions about alcohol’s effects on cardiovascular disease risk. For example, several high-quality Mendelian Randomization studies have suggested that the observed association between alcohol consumption and cardiovascular disease (CVD) is unlikely to be causal.
• Examine the potential for competing risks—acknowledging that alcohol may exert both harmful and potentially beneficial effects, and that disentangling these separate effects remains a major challenge for cardiovascular research.
• Examine the role of alcohol use in global health, health disparities, and the effectiveness of public health prevention strategies targeting cardiovascular disease.
• Assess the impact of public health interventions, policy measures, and individualized approaches (pharmacologic or non-pharmacologic) that address alcohol-related cardiovascular risk.
• Advance understanding of risk stratification, prediction, and prognostication of cardiovascular disease incorporating alcohol as a modifiable lifestyle factor.
• Investigate the mechanisms whereby ethanol and its primary metabolite, acetaldehyde, induce cardiac, vascular or endothelial dysfunction.
• Explore cellular/molecular mechanisms in human subjects, animal models, and cell culture systems (endothelial cells, smooth muscle cells, fibroblasts, stem cells, myocytes, and monocytes/macrophages).
Submissions should ideally leverage data from clinical or cohort studies, population-based research, or health systems databases involving human participants. Studies on the mechanistic effects of alcohol and its components are welcome only if they directly link to clinical endpoints or risk prediction in human populations and contribute to understanding the prevention, treatment, or risk stratification of cardiovascular diseases.

The Topic Editors welcome original research articles, systematic reviews, meta-analyses, and well-justified brief reports that advance knowledge of the determinants and prevention of cardiovascular disease, with particular attention to the multifaceted role of alcohol consumption.

Are you interested in contributing a manuscript to this Research Topic?

Alcohol Consumption and Cardiovascular Risk: Unraveling Mechanisms, Methods, and Prevention in Human Populations