Does Alcohol Raise Blood Pressure?

“The population that drinks moderately is two times at higher risk for getting hypertension than those who don’t drink,” says Prashant Vaishnava, M.D., assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons, and codirector of inpatient clinical services for Columbia Interventional Cardiovascular Care. “Those who drink heavily are three times as likely to be hypertensive” as those who abstain.

Does that mean you have to give up drinking altogether? How risky is the occasional drink? Answers ahead.

How does alcohol affect blood pressure?

Paradoxically, research suggests that booze may lower blood pressure at first — specifically, up to 12 hours after ingestion — but it increases blood pressure after that. Why the reverse course?

Alcohol initially relaxes the blood vessels; then those vessels start to constrict once the liver gets involved and begins to metabolize it. That’s true for all adults. “Both men and women appear to have a direct relationship between alcohol consumption and systolic blood pressure,” says Matthew Tomey, M.D., a cardiologist at the Mount Sinai Fuster Heart Hospital in New York City.

Also playing a role in the relationship between alcohol and blood pressure: alcohol’s empty calories, which can lead to weight gain, itself a risk factor for hypertension. “Be cognizant of the calories that come with alcoholic beverage consumption, not only from the alcohol but from the other ingredients in a given beverage,” Tomey advises. 

Studies have shown that a good percentage of people who drink alcohol also smoke, which can raise blood pressure as well.

What are the age-related risk factors of alcohol on blood pressure?

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Older adults — drinkers, nondrinkers, it doesn’t matter — are already at risk for hypertension. Research suggests that 74.5 percent of people 60 and older have high blood pressure, compared with 54.5 percent of adults ages 40 to 59. Several factors are to blame, one being your body’s network of blood vessels, which changes with age. Arteries get stiffer, causing blood pressure to go up.  

That’s partly why people who drink may find that although they’re consuming the same amount they always have, they feel the effects more quickly or strongly — that’s especially true for older women, according to the National Institute on Aging. A slower metabolism also plays a role, as do medications — prescription, over-the-counter, even herbal remedies — that are common among older people. “As you grow older, health problems or prescribed medicines may require that you drink less alcohol or avoid it completely,” the Institute says.

“Some of the new diabetes medications have a diuretic effect, and that could cause dehydration” in people with diabetes, Vaishnava says. Alcohol causes a diuretic effect as well. Research shows that regular use of acetaminophen can raise blood pressure, as can nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen. If you already have high blood pressure, NSAIDs can prevent several common meds such as ACE inhibitors and diuretics from doing their job.

Other over-the-counter products to be aware of: Decongestants, which relieve stuffiness by narrowing blood vessels to reduce swelling in the nose, can raise blood pressure. So can supplements such as ginseng and ephedra.

What about wine and high blood pressure?

For a while, red wine seemed to offer a free pass to people who like to drink. But does it lower blood pressure? Beginning in the ’90s, experts talked up the virtues of red wine, citing research that suggested its high level of polyphenols (good-for-you compounds found in plants) protected against health woes including high blood pressure, as well as cardiovascular disease in general, macular degeneration, Alzheimer’s and cancer. In particular, the polyphenol resveratrol, which is found in red wine, was associated with cardiovascular benefits.

Those experts basically echoed research showing that “polyphenols can have a positive impact on lowering LDL (bad) and raising HDL (good) cholesterol,” Vaishnava says. “That isn’t necessarily untrue, but some of the other evidence points toward variables that could be impacting the positive effects of those who drink red wine — meaning maybe they have healthier lifestyles anyway.”

In any case, red wine has lost its health halo. Has it been replaced? Are there any alcoholic drinks that lower blood pressure? Alas, no, Vaishnava says, adding that “it’s important to be mindful of what constitutes a drink: one 12-ounce beer, one 5-ounce glass of wine or 1.5 ounces of hard liquor. If someone is looking for a suggestion, we give the guardrails of one drink per day for women and two per day for men — usually wine.”

Does quitting alcohol lower blood pressure?

Yes. Heavy drinkers who cut back to moderate drinking can lower the all-important top number in their blood pressure reading by about 5.5 mm Hg (millimeters of mercury, a measurement for pressure) and their bottom number by about 4 mm Hg, according to the Mayo Clinic.

“What I would tell my patients, friends and family is this: If you drink too much, focus on drinking less,” Tomey says. “If you don’t drink, don’t start.”