Several epidemiological data both on apparently healthy people and on patients with a history of cardiovascular events, indicate a consistent risk reduction in cardiovascular events or all-cause mortality among moderate alcohol drinkers, but, on the other hand, the harm of excess and irregular drinking. If cardiovascular patients are heavy alcohol drinkers, they must be strongly advised to abstain or at least substantially reduce alcohol drinking in the range of the "protective windows" showed in recent meta-analyses; if not contraindicated, regular alcohol consumers should not exceed one drink/day for women or up to two drinks/day for men as a component of a balanced cardio-protective dietary pattern with appropriate energy intake levels. At present, we believe that a cardiovascular patient who is teetotaler should neither be recommended, nor "prescribed" to start drinking for health gain. This patient, however, must be properly informed of the potential health benefits of a regular habit of drinking alcohol in moderation.