alcohol and hypertension

Last reviewed 12/2022

Alcohol has been identified as a major contributor to the elevation of blood pressure:

• it has a pressor effect that is independent of all known variables

• it has additive effects to obesity and to use of the oral contraceptive pill in the development of hypertension

• individuals who have 3 or more standard drinks daily show a 3 fold increase in the prevalence of mild hypertension - blood pressure >= 140 / 90 mm Hg - compared with non-drinkers

• the pressor effect of alcohol develops within a few days of excessive intake

• the hypertensive effect of alcohol usually recedes within a few days of abstinence

Previous guidance stated that hypertensive patients should be advised to limit their alcohol intake to 21 units/week (men) and 14 units per/week (women)..Consumption of smaller amounts of alcohol, up to the recommended limit, may protect against CHD and should not be discouraged (3).

However latest guidance for men and women states that (4):

• you are safest not to drink regularly more than 14 units per week, to keep health risks from drinking alcohol to a low level
  

Notes (5):

• structured interventions to reduce alcohol consumption, or substitute low alcohol alternatives, have had a modest effect on blood pressure, reducing systolic and diastolic blood pressure on average by about 3-4 mmHg in trials. Thirty percent of patients were estimated to achieve a reduction in systolic blood pressure of 10 mmHg systolic or more in the short term, up to 1 year

Reference:

1. Drugs and Therapeutics Bulletin (1996), Drugs and alcohol: harmful cocktails?, 34 (5), 36-8.
2. Kaplan NM (1995). Alcohol and hypertension. Lancet, 345, 1588.
3. Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens 2004;18: 139-8
4. DOH (January 2016). How to keep health risks from drinking alcohol to a low level: public consultation on proposed new guidelines.
5. NICE (June 2006). Management of hypertension in adults in primary care