What You Need To Know About Alcohol And High Blood Pressure

Over time, heavy consumption of alcohol can lead to chronic conditions like high blood pressure, heart disease, liver disease, and even cancer.

According to studies, having more than three drinks¹ a day is associated with increased hypertension (high blood pressure) and cardiovascular diseases.

High blood pressure is sometimes referred to as “the silent killer” due to a lack of noticeable symptoms. It is also a high-risk factor for cardiovascular diseases and heart failure.

Lifestyle is a major cause of high blood pressure, and alcohol is among those unhealthy lifestyle choices. Excessive drinking can lead to hypertension either directly or indirectly, and it is estimated that about 10% of high blood pressure² cases in the general population can be linked to alcohol.

Read on to understand the relationship between alcohol consumption and high blood pressure.

How does alcohol impact blood pressure?

There are many ways that alcohol can increase the risk of hypertension, whether directly or indirectly. The immediate and direct effects are often related to how the alcohol is processed in the body.

Many studies find that regular drinkers have a higher risk of high blood pressure than non-drinkers. Also, studies have found³ that heavy drinkers (more than 30 drinks per week) are twice as likely as non-drinkers to develop any type of hypertension.

Alcohol can lead to hypertension in the following ways:

Renin-angiotensin-aldosterone system

The renin-angiotensin-aldosterone system (RAAS) plays a critical role in regulating blood volume and systemic vascular resistance.

The system is made up of the three compounds in its name, and they act to increase arterial pressure in response to lower renal blood pressure.

Alcohol elevates the blood levels of the renin compound, which results in the blood vessels constricting, making them smaller in diameter. An increase in the renin hormone also decreases how much fluid the body eliminates as urine, raising fluid levels within the body.

The combination of smaller blood vessels and more fluids increases the chances of hypertension.

Vasopressin levels

Antidiuretic hormone (ADH), also known as vasopressin, is a hormone responsible for the body holding onto water which typically limits the urine volume the kidneys make. When people drink alcohol, vasopressin is suppressed.

As a result, the body overcompensates by releasing more vasopressin, which can cause an increase in blood pressure.

Cortisol levels

Cortisol is the primary hormone for stress and plays an important part in regulating inflammation, immune function, and metabolism. However, too much cortisol for extended periods often leads to Cushing's syndrome, symptoms of which include hypertension, osteoporosis, and mood swings.

Drinking alcohol increases cortisol levels,⁴ especially with long-term heavy drinking. Ultimately, this can induce cardiovascular changes, leading to high blood pressure.  

Blood calcium levels  

The consumption of alcohol is known to increase the amount of calcium that tends to get bound to the arterial and arteriolar smooth muscle cells. This results in increased sensitivity of the blood vessels to compounds that constrict them.

The constriction of blood vessels means that the heart has to pump harder, which results in increased blood pressure.

Guidelines for drinking alcohol if you have high blood pressure or are at risk of developing it

If you have high blood pressure or are at risk of developing it, it would be best to avoid alcohol entirely or drink it in very moderate amounts. For healthy people, moderate translates to one or two drinks a day, no matter the type of alcohol.

There are different definitions of excessive drinking that can help you understand various types of alcohol consumption:

  • Binge-drinking: having four or more drinks for women and five or more drinks for men in a single occasion

  • Moderate drinking: less than or up to two drinks a day for men and one drink for women

  • Heavy drinking: more than 15  drinks per week for men and eight drinks per week for women

According to a large-scale study⁵ with more than 17,000 participants, those categorized as moderate or heavy drinkers were at a higher risk for high blood pressure than those who didn’t drink alcohol.

In another study,⁶ binge drinking was more likely to increase systolic blood pressure.

If you take high blood pressure medication, you should be especially cautious of consuming alcohol. Certain types of hypertension medication, such as alpha-blockers, beta-blockers, and nitrates, can have dangerous interactions with alcohol.

The majority of high blood pressure medications come with possible side effects of dizziness that can occur due to lowering blood pressure. Too much alcohol can also worsen reduced blood pressure, resulting in more dizziness, drowsiness, and possible fainting. The combination of the two can lead to more falls and accidents. 

Will quitting alcohol lower blood pressure?

 A study has reported that⁷ heavy drinkers who completely stopped drinking for a month managed to lower their systolic pressure by about 7.2 mm Hg and their diastolic pressure by 6.6mm Hg.

Almost 72% of these participants, who were initially categorized as hypertensive, were no longer considered so after giving up alcohol for a month.

The results showed that excessive consumption of alcohol played a critical role in increasing blood pressure. So, drinking in moderation or quitting altogether is recommended as part of the treatment for high blood pressure in people who regularly consume high amounts of alcohol. 

Moderate consumption or abstinence

Moderating or abstaining from alcohol consumption is the best non-medical option available for lowering alcohol-induced high blood pressure. These behaviors can also help prevent the development of high blood pressure among healthy adults.

Try to gradually reduce consumption to one or two drinks per day; then, try to stop drinking altogether. If you have problems moderating or limiting alcohol consumption, there are many options available for support, such as rehab and counseling.   

Non-pharmacological treatment

Lack of exercise and an inactive lifestyle can contribute to the development of high blood pressure, and studies have shown that physical activity helps control blood pressure.

Alcohol can directly lead people to become overweight or obese, which are high-risk factors for developing high blood pressure. As a result, limiting alcohol consumption and maintaining a decent level of physical activity and exercise can help lower your high blood pressure

Pharmacological treatment

There are some pharmacological medications available to help lower alcohol-related hypertension.

ACE inhibitors/angiotensin II receptor type 1 (AT1) blockers can help manage alcohol-induced high blood pressure. The medication's ability to elevate cardiac output in individuals with cardiomyopathy caused by alcohol can be helpful in the treatment of alcohol-induced hypertension.

Additionally, calcium-channel blockers can help. Since managing alcoholism can lower blood pressure numbers, some medications focus on helping people quit drinking. The ingredients in these medications include acamprosate, oral naltrexone, and disulfiram.    

The lowdown

Alcohol can lead to high blood pressure, and excessive drinking can be a major cause. Alcohol usually affects multiple body systems, increasing the risk of developing hypertension.

Fortunately, alcohol-induced hypertension is reversible, especially when people moderate or abstain from alcohol for long periods. Regular physical activity is also an effective treatment method for alcohol-induced hypertension.

Medications can also treat acute alcohol-induced hypertension episodes or manage the condition long-term.


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