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Background: An exaggerated heart rate (HR) increase following alcohol intoxication has been suggested to reflect sensitivity to alcohol-induced reward. The goal of this study is to verify whether pairing alcohol ingestion with conditioned reward and nonreward cues can influence HR responses to alcohol in previously identified individuals with a low and a high HR response. Methods: Fifty-six male social drinkers participated in a 2-day study. On day 1, participants consumed 0.75 g/kg of body weight of pure ethanol. A median split of the alcohol-induced HR responses identified groups of low and high HR responders. On day 2, both groups participated while sober in a computer task where distinct auditory and visual cues were paired either with monetary reward or no monetary reward. Subsequently, participants were randomly assigned to an alcohol challenge, which occurred while they were exposed to either the conditioned cues of reward or to the nonreward cues. Results: The physiological response to alcohol intoxication on day 2 was compared with alcohol-induced HR responses on day 1 (neutral alcohol challenge) for both low and high HR responders. Paired t-tests showed that high HR responders had significantly decreased alcohol-induced HR responses on day 2 in the nonreward condition when compared with day 1. No other relationships between cardiac responses to alcohol and cue conditions were obtained. Conclusions: The rewarding nature of alcohol can be altered by the context in which it is consumed in a subset of individuals who are sensitive to alcohol's stimulating properties. [ABSTRACT FROM AUTHOR]