Moderate alcohol consumption has been associated with lower coronary heart disease (CHD) risk. However, the impact of higher alcohol consumption on cardiovascular risk factors (CVRFs) is conflicting. We examined the association between alcohol consumption, CVRFs and the estimated 10-year CHD risk in the population-based CoLaus study in Lausanne, Switzerland. Among 5,769 participants without cardiovascular disease, 73% of the participants were alcohol drinkers; 16% consumed 14-34 drinks/week and 2% consumed > or = 35 drinks/week. This article shows the impact of high alcohol consumption on CVRFs and reviews the literature on the associations between alcohol consumption and CVRFs.