Background The health and social impact of drinking in excess of internationally recognized weekly (>21 units in men; >14 units in women) and daily (>4 units in men; >3 units in women) recommendations for ‘sensible’ alcohol intake are largely unknown. Methods A prospective cohort study of 1551 men and women aged around 55 years in 1988 when typical alcohol consumption was recalled using a 7-day grid. An average of 3.4 years later (1990/92), study participants were re-surveyed (n = 1259; 84.7% of the target population) when they responded to nurse-administered enquiries regarding minor psychiatric morbidity, self-perceived health, hypertension, accidents, overweight/obesity and financial difficulties. Study members were followed up for mortality experience over 18 years. Results In fully adjusted analyses, surpassing guidelines for sensible alcohol intake was associated with an increased risk of hypertension [daily guidelines only: P-value(trend): 0.012], financial problems [weekly guidelines: P-value(difference): 0.046] and, to a lesser degree, accidents [weekly guidelines: P-value(difference): 0.065]. There was no association between either indicator of alcohol intake and mortality risk. Conclusions In the present study, there was some evidence for a detrimental effect on health and social circumstances of exceeding current internationally recognized weekly and daily guidelines for alcohol intake.