OBJECTIVE: To determine associations between demographic characteristics, alcohol use, heavy episodic drinking (HED), and cardiovascular risk factors using the 2016 Guyana World Health Organization (WHO) STEPwise noncommunicable diseases risk factor survey. METHODS: A weighted sample was used in a secondary analysis of data obtained from an online database. Descriptive statistics, binary logistic regression, and linear regression models were applied to identify which subpopulations were at highest risk of HED or cardiovascular disease. RESULTS: Data from 2 662 individuals (77% response rate) were analyzed. In the unweighted sample, females made up 59.9% (95% CI [58.04, 61.76]) of the respondents and the average age was 40.7 years. Indo-Guyanese comprised 39.4% (95% CI [37.54, 41.26]) of the sample. The maximum educational level completed was primary level in 44.5% (95% CI [42.61, 46.39]) and secondary in 32.5% (95% CI [30.72, 34.28]). Of those who had ever drunk, 80.1% (95% CI [78.30, 81.90]) confirmed alcohol use in the past 12 months. Younger males were significantly more likely to consume alcohol. Using the weighted sample, Amerindian individuals had lower odds of alcohol use (odds ratio [OR] 0.36; 95% CI [0.25, 0.51]) compared to Indo-Guyanese. Residents of the Demerara-Mahaica region had the highest use at 86.1% (OR 4.74; 95% CI [2.86, 7.86]). Regarding HED, 16.4% (95% CI [14.73, 18.07]) of the entire sample, and 41.1% (95% CI [38.88, 43.32]) of those who drank in the past 30 days, reported having at least six drinks (defined as HED) in one sitting. The 25-29 age group showed an increase in odds for HED (OR 2.09; 95% CI [1.13, 3.89]). Men were more likely to engage in HED than women (OR 6.13; 95% CI [4.73, 7.95]). People of African (OR 0.78; 95% CI [0.61, 1.00]) and Amerindian descent (OR 0.48; 95% CI [0.31, 0.73]) had lower odds of HED than Indo-Guyanese. In the adjusted models, HED was positively correlated with elevated blood pressure (adjusted OR [aOR] 1.40; 95% CI [1.05, 1.88]), obesity (aOR 1.49; 95% CI [1.13, 1.95]), and elevated triglycerides ( coefficient 28.38, = 0.004). For each OR and aOR above, ≤ 0.05. CONCLUSIONS: This secondary analysis identifies that the population along the central and eastern coastal regions, young males, and those of Indo-Guyanese descent might benefit from focused public health interventions on alcohol and cardiovascular risk in Guyana.