• Posted July 31, 2023

Regular Drinking Can Raise Blood Pressure in the Otherwise Healthy

Whether knocking back a little alcohol or a lot, daily drinking is tied to higher blood pressure, a new research review warns.

Compared with not drinking, just one alcoholic drink a drink a day is associated with higher blood pressure over time, even in people who previously had normal blood pressure levels, according to researchers who analyzed the results of seven prior studies.

The upshot: Drinking and blood pressure control don't mix, said study lead author Dr. Marco Vinceti. As blood pressure, or hypertension, rises, so do the odds for heart disease and stroke.

How much is too much? “Clearly, the lower the better, and no consumption even better," said Vinceti, a professor of epidemiology and public health in the Medical School of the University of Modena and Reggio Emilia University in Italy.

The review involved more than 19,000 adults in all, from the United States, Korea and Japan. Patients in each study were tracked for more than five years.

The findings indicate "that a positive -- [meaning] direct -- relation between alcohol intake and blood pressure increases over time exists, even at low alcohol intake, something that was unclear and debated so far in the scientific literature," explained Vinceti.

“Alcohol is not the only or necessarily the main determinant of high blood pressure,” he added. "And the effects of small intakes of alcohol are certainly not biologically as relevant as high intakes for blood pressure changes.”

Besides alcohol, other contributors to high blood pressure include unhealthy diet, obesity, physical inactivity and tobacco use, says the U.S. Centers for Disease Control and Prevention.

Compared with nondrinkers, the study team determined that men and women who drank an average of 12 grams of alcohol a day saw their systolic (top number) blood pressure number rise by 1.25 mm Hg. (Twelve grams of alcohol is a little less than that in a 12-ounce can of beer, a 5-ounce glass of wine, or a 1.5-ounce shot of spirits.)

Those who consumed about four times that average amount, or 48 grams of alcohol daily, saw their systolic number rise by 4.9 mm Hg, the researchers said.

Diastolic readings (the bottom number) also went up with drinking, but only among men. Drinking an average of 12 grams of alcohol daily caused that number to rise by 1.14 mm HG. That figure rose to 3.1 mm among those who consumed an average of 48 grams per day. (The study team points out that systolic pressure is a more reliable predictor of long-term heart disease risk.)

It's not entirely clear why alcohol would drive up blood pressure, said co-author Dr. Paul Whelton, chair of global public health at Tulane University School of Public Health and Tropical Medicine in New Orleans. Still, the most likely explanation is that "alcohol increases BP by activating the sympathetic ‘fight and flight' system," said Whelton, who is also president of the World Hypertension League.

He and Dr. Nieca Goldberg, an expert volunteer with the American Heart Association, said the link might also be rooted in the way alcohol drives up levels of the stress hormone cortisol.

The connection could also source back to the way the kidneys regulate blood pressure, said Goldberg, a clinical associate professor of medicine at the NYU Grossman School of Medicine in New York City. She wasn't involved in the study.

Regardless, Whelton offered simple advice: “If you're not drinking, don't start. If you are drinking, try to reduce your intake or quit drinking.” This is especially true if your blood pressure is in the high normal range, he said, adding that study participants with higher starting blood pressure readings had a stronger link between alcohol intake and blood pressure changes over time.

"The takeaway message," said Goldberg, "is that alcohol is not a preventive therapy for high blood pressure or heart disease. To lower blood pressure and maintain heart health, incorporate a Mediterranean-style diet, lower salt intake, find exercise activities that you like, lower stress and try to improve your sleep to six to eight hours a night."

The study findings appear July 31 in the journal Hypertension.

More information

There's more on alcohol and blood pressure at the American Heart Association.

SOURCES: Marco Vinceti, MD, PhD, professor, epidemiology and public health, Medical School of the University of Modena and Reggio Emilia University, Italy, and adjunct professor, epidemiology, Boston University; Paul Whelton, MD, MSc, chair, global public health, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, and president, World Hypertension League; Nieca Goldberg, MD, FACC, expert volunteer, American Heart Association, and clinical associate professor of medicine, NYU Grossman School of Medicine, New York City; Hypertension, July 31, 2023