Background: Light-to-moderate alcohol consumption is associated with a decreased risk of ischemic cardiovascular disease, whereas increased alcohol intake is related to hypertension and intracerebral hemorrhage. We studied the effect of alcohol consumption on the augmentation index (AIx), a measure of arterial wave reflection in a population of healthy young men. Methods: Three hundred twenty-nine men (mean age 28 years) from the Atherosclerosis Risk in Young Adults study (ARYA-study) were studied. The level of alcohol consumption and risk factors for cardiovascular disease were determined. The AIx was estimated by radial applanation tonometry using a Sphygmocor device. The relation between alcohol intake level and AIx was determined using linear regression models. Results: There was a positive graded relation between alcohol intake and AIx. Subjects who did not drink, who drank 1 to 2 glasses/d, or who drank ≥3 glasses of alcohol/d had, respectively, a -0.6% (95% confidence interval [CI] -4.2, 3.0), 0.2% (95% CI -2.6, 2.9), and 3.4% (95% CI 0.2, 6.7) difference in AIx compared with very light drinkers (<1 glass/d). After adjustment for current smoking, body mass index and HDL-cholesterol, those consuming >3 glasses/d had a 3.29% (95% confidence interval CI 0.01, 6.7) higher AIx compared with those consuming <1 glass/d. Conclusions: In a population of healthy young men, the heaviest drinkers had a significantly higher AIx. This finding supports the evidence that increased alcohol consumption is related to vascular damage at young age. © 2005 American Journal of Hypertension, Ltd.