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Routinely Drinking Alcohol May Raise Blood Pressure Even Without Hypertension

Even in adults without hypertension, blood pressure readings may climb more steeply over the years as the number of daily alcoholic drinks rise, according to an analysis of seven international research studies published in Hypertension, an American Heart Association (AHA) journal.
With the statistical power of seven international research studies, this analysis confirms for the first time there was a continuous increase in blood pressure measures in both participants with low and high alcohol intake. Even low levels of alcohol consumption were associated with detectable increases in blood pressure levels that may lead to a higher risk of cardiovascular events.
“We found no beneficial effects in adults who drank a low level of alcohol compared to those who did not drink alcohol,” says senior study author Marco Vinceti, MD, PhD, a professor of epidemiology and public health in the Medical School of the University of Modena and Reggio Emilia University in Italy and an adjunct professor in the department of epidemiology at Boston University’s School of Public Health. “We were somewhat surprised to see that consuming an already low level of alcohol was also linked to higher blood pressure changes over time compared to no consumption—although far less than the blood pressure increase seen in heavy drinkers.”
“Our analysis was based on grams of alcohol consumed and not just on the number of drinks to avoid the bias that might arise from the different amount of alcohol contained in ‘standard drinks’ across countries and/or types of beverages,” says study coauthor Tommaso Filippini, MD, PhD, an associate professor of epidemiology and public health in the Medical School of the University of Modena and Reggio Emilia in Italy, and affiliate researcher at the University of California Berkeley School of Public Health.
Researchers reviewed the health data for all participants across the seven studies for more than five years. They compared adults who drank alcohol regularly with nondrinkers and found the following:
• Systolic blood pressure rose 1.25 mm Hg in people who consumed an average of 12 g of alcohol per day, rising to 4.9 mm Hg in people consuming an average of 48 g alcohol per day. (In the United States, 12 oz of regular beer, 5 oz of wine, or a 1.5-oz shot of distilled spirits contains about 14 g alcohol. Usual alcohol content differs in alcohol available in other countries.)
• Diastolic blood pressure rose 1.14 mm Hg in people consuming an average of 12 g alcohol per day, rising to 3.1 mm Hg in people consuming an average of 48 g alcohol per day. These associations were seen in males but not in females. Diastolic blood pressure measures the force against artery walls between heartbeats and isn’t as strong a predictor of heart disease risk in comparison to systolic.
“Alcohol is certainly not the sole driver of increases in blood pressure; however, our findings confirm it contributes in a meaningful way. Limiting alcohol intake is advised, and avoiding it is even better,” Vinceti says.
Although none of the participants had high blood pressure when they enrolled in the studies, their blood pressure measurements at the beginning did have an impact on the alcohol findings.
”We found [that] participants with higher starting blood pressure readings had a stronger link between alcohol intake and blood pressure changes over time. This suggests that people with a trend towards increased (although still not “high”) blood pressure may benefit the most from low to no alcohol consumption,” says study coauthor Paul K. Whelton, MD, MSc, the Show Chwan chair in Global Public Health in the department of epidemiology at Tulane University’s School of Public Health and Tropical Medicine in New Orleans and president of the World Hypertension League. Whelton is also the chair of the AHA’s 2017 Hypertension Practice Guidelines and a member of the writing committee for the AHA’s 2021 Scientific Statement on Management of Stage 1 Hypertension in Adults.
According to AHA recommendations, if you don’t drink already, don’t start. If you do drink, talk with your doctor about the benefits and risks of consuming alcohol in moderation. The AHA also doesn’t recommend drinking any form of alcohol to gain potential health benefits. Instead, follow the AHA’s lifestyle and health metrics for optimal cardiovascular health called Life’s Essential 8: eat healthful food, be physically active, don’t smoke, get enough sleep, maintain a healthy weight, and control cholesterol, blood sugar, and blood pressure levels.
Study details and background include the following:

  • Researchers analyzed data from seven large, observational studies involving 19,548 adults (65% men), ranging in age from 20 to their early 70s at the start of the studies.
  • The studies were conducted in the United States, Korea, and Japan, and published between 1997 and 2021. None of the participants previously had been diagnosed with high blood pressure or other CVDs, diabetes, liver disease, alcoholism, or binge drinking.
  • Usual alcoholic beverage intake was recorded at the beginning of each study and the researchers translated this information into a usual number of grams of alcohol consumed daily. The researchers used a new statistical technique that allowed them to combine results from several studies and plot a curve showing the impact of any amount of alcohol typically consumed on changes in blood pressure over time.
  • Systolic blood pressure, the top number in a blood pressure reading, measures the force against the artery walls when the heart contracts. It rises steadily with age and is a strong predictor of CVD risk. Effective blood pressure management is vital to reduce, prevent, or delay the development of high blood pressure.

Source: American Heart Association