Manufacturers of angiotensin-converting enzyme (ACE) inhibitors have no information or recommendation regarding the specific use of ACE inhibitors while drinking alcohol.1-14
According to the 2017 American College of Cardiology and American Heart Association (ACC/AHA) hypertension guidelines, there is a direct relationship between alcohol consumption and blood pressure. 15 The increase in blood pressure is approximately 1 mmHg for each 10 grams of alcohol consumed and is largely reversible within 2-4 weeks of stopping or reducing alcohol intake.16
It is recommended to maintain moderate drinking habits as defined by the U.S. Department of Health and Human Services: 1 drink or less a day for women and 2 drinks or less a day for men.16 For those with high blood pressure, reducing alcohol intake to this amount resulted in an average reduction of blood pressure by -4 mm Hg systolic and -3mm Hg diastolic or more, regardless of other interventions. 15-16,18-21
Dizziness is a reported side effect occurring in 0.5-2% greater frequency in patients treated with ACE inhibitors than placebo. These side effects can be accentuated by alcohol, which also causes dizziness. Manufacturers warn that hypotension can occur in patients with salt/volume depletion, which can result from alcohol-caused dehydration or vomiting.1-14
References
- Lotensin [package insert]. Parsippany, NJ: Validus Pharmaceuticals LLC; 2019.
- Capoten [package insert]. Chestnut Ridge, NY: Par Pharmaceutical; 2017.
- Epaned [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
- Vasotec [package insert]. Bridgewater, NJ: Bausch Health US LLC; 2018.
- Enalaprilat [package insert]. Lake Forest, IL: Hospira, Inc.; 2021.
- Monopril [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2003.
- Qbrelis [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
- Prinivil [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2021.
- Zestril [package insert]. Morristown, NJ: Almatica Pharma LLC; 2020.
- Univasc [package insert]. Smyrna, GA: USB, Inc; 2012.
- Aceon [package insert]. Cincinnati, OH: Patheon Pharmaceuticals, Inc.; 2017.
- Accupril [package insert]. New York, NY: Parke Davis, Pfizer; 2021.
- Altace [package insert]. New York, NY: Pfizer Laboratories; 2022.
- Mavik [package insert]. Whippany, NJ: Halo Pharmaceutical Inc.; 2017.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension 2017.
- Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol 2006; 33 (9): 847-852.
- Dietary Guidelines for Americans, 2020-2025, 9th Ed: U.S. Department of Health and Human Services and U.S. Department of Agriculture; 2020.
- Roerecke M, Kaczorowski J, Tobe SW, Gmel G, Hasan OSM, Rehm J. The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis. Lancet Public Health 2017; 2 (2): e108-e120.
- Stewart SH, Latham PK, Miller PM, Randall P, Anton RF. Blood pressure reduction during treatment for alcohol dependence: results from the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study. Addiction 2008; 103 (10): 1622-1628.
- Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2001; 38 (5): 1112-1117.
- Lang T, Nicaud V, Darne B, Rueff B. Improving hypertension control among excessive alcohol drinkers: a randomised controlled trial in France. The WALPA Group. J Epidemiol Community Health 1995; 49 (6): 610-616.
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