This study investigates the causal relationship between alcohol consumption and cardiovascular diseases (CVDs) using Mendelian randomization (MR). The researchers used up to 94 single-nucleotide polymorphisms (SNPs) as instrumental variables for alcohol consumption, with genetic association estimates obtained from large-scale consortia and the UK Biobank. The analyses were conducted using various MR methods, including inverse variance-weighted, weighted median, MR-PRESSO, MR-Egger, and multivariable MR. The results consistently showed that genetically predicted alcohol consumption was associated with an increased risk of stroke and peripheral artery disease. The odds ratios (ORs) per 1-SD increase in log-transformed alcoholic drinks per week were 1.27 for stroke and 3.05 for peripheral artery disease in the inverse variance-weighted analysis. There was also some evidence of positive associations with coronary artery disease, atrial fibrillation, and abdominal aortic aneurysm, but these associations were attenuated after adjusting for smoking initiation. No significant associations were found with heart failure, venous thromboembolism, and aortic valve stenosis. The study concludes that higher alcohol consumption is causally associated with an increased risk of stroke and peripheral artery disease, while the causal role of alcohol consumption for other CVDs requires further research. The findings confirm previous MR studies and provide additional insights into the complex relationship between alcohol consumption and CVDs.This study investigates the causal relationship between alcohol consumption and cardiovascular diseases (CVDs) using Mendelian randomization (MR). The researchers used up to 94 single-nucleotide polymorphisms (SNPs) as instrumental variables for alcohol consumption, with genetic association estimates obtained from large-scale consortia and the UK Biobank. The analyses were conducted using various MR methods, including inverse variance-weighted, weighted median, MR-PRESSO, MR-Egger, and multivariable MR. The results consistently showed that genetically predicted alcohol consumption was associated with an increased risk of stroke and peripheral artery disease. The odds ratios (ORs) per 1-SD increase in log-transformed alcoholic drinks per week were 1.27 for stroke and 3.05 for peripheral artery disease in the inverse variance-weighted analysis. There was also some evidence of positive associations with coronary artery disease, atrial fibrillation, and abdominal aortic aneurysm, but these associations were attenuated after adjusting for smoking initiation. No significant associations were found with heart failure, venous thromboembolism, and aortic valve stenosis. The study concludes that higher alcohol consumption is causally associated with an increased risk of stroke and peripheral artery disease, while the causal role of alcohol consumption for other CVDs requires further research. The findings confirm previous MR studies and provide additional insights into the complex relationship between alcohol consumption and CVDs.