According to the 2017 ACC/AHA Hypertension Guidelines alcohol is a substance that has the potential to impair blood pressure control.1 They recommend limiting alcohol to ≤1 drink daily for women and ≤2 drinks for men. In the United States, one “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol).1-3 Evidence reviewed by the panel shows that for heavy drinkers, reducing alcohol intake to this amount may result in a reduction of blood pressure by 4 mm Hg systolic and 3mm Hg diastolic or more, regardless of other interventions.1,4-7
A 2017 systematic review and meta-analysis found 36 trials (n=2,865) that studied the effect of reducing alcohol intake on blood pressure.4 The studies varied with only hypertensive participants (13 trials), participants with a mix of hypertension and normal blood pressure (12 trials), and normotensive only (13 trials). Analysis found that blood pressure was most reduced for participants who drank six or more drinks per day if they reduced their intake by at least 50% with the mean difference in systolic blood pressure of -5.50 mm Hg (95% confidence interval [CI] [-6.70 – -4.30]) and in diastolic blood pressure of -3.97 mm Hg (95% CI [-4.70 – -3.25]). No significant reduction in blood pressure was found when people who had two or less drinks a day reduced their intake. Blood pressure reduction was still significant but more moderate for people who reduced alcohol intake from three drinks per day with a reduction in systolic blood pressure of -1.18 mm Hg (95% CI [-2.32 – -0.04]) and in diastolic blood pressure of -1.09 mm Hg (95% CI [-1.61 – 0.57]).
Excessive alcohol consumption causes about 16% of hypertension cases worldwide.8,9 Drinking more than two alcoholic drinks per day raises the risk of high blood pressure.10,11
The Dietary Guidelines for Americans 2015-2020 states that if alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age. For those who choose to drink, moderate alcohol consumption is recommended.12
References
- 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: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017.
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). What is a standard drink? https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/what-standard-drink. Accessed Mar 17, 2018.
- Moyer VA. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2013; 159 (3): 210-218.
- 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.
- Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol 2006; 33 (9): 847-852.
- Husain K, Ansari RA, Ferder L. Alcohol-induced hypertension: Mechanism and prevention. World J Cardiol 2014; 6 (5): 245-252.
- Taylor B, Irving HM, Baliunas D, et al. Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. Addiction 2009; 104 (12): 1981-1990.
- Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: the atherosclerosis risk in communities study. Hypertension 2001; 37 (5): 1242-1250.
- 2015 – 2020 dietary guidelines for Americans. 8 ed: U.S. Department of Health and Human Services and U.S. Department of Agriculture; 2015.
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