Quality Of The Evidence
We graded the overall certainty of evidence using the GRADE approach via GRADEpro GDT software we formulated summary of findings tables.
We created three SoF tables to show the certainty of evidence and the summary of effects on outcomes of interest for high , medium , and low doses of alcohol.
Ratings of the certainty of evidence ranged from moderate to low in this review, which suggests that the effect estimates of alcohol might be slightly different than the true effects. For high doses of alcohol, we found moderatecertainty evidence showing a decrease in SBP and lowcertainty evidence suggesting a decrease in DBP within the first six hours and 7 to 12 hours after consumption. Moderatecertainty evidence shows that SBP and DBP rise between 13 and 24 hours after alcohol ingestion.
For medium doses of alcohol, moderatecertainty evidence shows a decrease in SBP and DBP six hours after alcohol consumption, and lowcertainty evidence suggests a decrease in SBP and DBP for 7 to 12 hours after alcohol consumption. After 13 hours of consumption, SBP and DBP were raised the certainty of evidence was low and medium, respectively.
For low doses of alcohol, we found lowcertainty evidence suggesting that SBP, DBP, and MAP fall within the first six hours after alcohol consumption.
Increases Hormone Blood Levels
Alcohol affects the central nervous system directly when you consume it. One of the results of this effect is the unbalanced release of hormones into the bloodstream.
Your body uses hormones to regulate itself and control responses to certain stimuli. When hormones are released as a result of the unnatural stimulus of alcohol, these unbalanced responses can result in hypertension.
For example, the bodys renin-angiotensin-aldosterone system disperses hormones in the bloodstream that regulate blood pressure.
One such hormone is renin, which causes your blood vessels to constrict. Alcohol use increases the production of renin, so when blood flow becomes more difficult in constricted vessels, it raises blood pressure.
What Is High Blood Pressure
Every time your heart beats, it pumps blood into the arteries, and blood pressure is the force of your blood pushing against the arterial walls.3 Every time your heart beats, blood pressure is at its highest and is measured as systolic pressure, which is the first number on a blood pressure reading.3 In between beats, blood pressure is relatively lower, which is known as diastolic pressure.3
Blood pressure measures include both a persons systolic and diastolic numbers, with the former coming before the latter. Some important blood pressure thresholds to know include:3
- Normal: Less than 120/80 mmHg.
- Prehypertension : Between 120/80 mmHg and 139/89 mmHg.
- Stage 1 Hypertension: Between 130-139 mmHg/80-89 mmHg.
- Stage 2 Hypertension: Higher than 140/90 mmHg.
- Hypertension Crisis : higher than 180/120 mmHg.
High blood pressure, or hypertension, is when a persons blood pressure stays elevated longer than normal.4 When it stays high over time, it causes the heart to consistently pump harder.3
The increased cardiovascular stress may lead to serious health problems such as:
- Heart attack
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Use Alcohol In Moderation
Alcohols role in providing heart-protective benefits is one of todays major health debates. Some research indicates that when used in moderation, alcoholic drinks can increase the good HDL cholesterol and reduce the risk of heart disease.
Both the Centers for Disease Control and Prevention and the AHA disagree. The AHA does not endorse drinking wine or any other alcoholic beverage specifically to lower your cholesterol or improve heart health. Both organizations say there is no credible research linking alcohol and improved heart health.
The AHA acknowledges there may be a small rise of the good HDL cholesterol with moderate alcohol use, but it says exercise is a better way to achieve this benefit.
Some research recommends that alcohol consumption recommendations be reconsidered in light of its harmful effects on cardiovascular health, even in lower amounts.
What especially worries researchers about recommending moderate use of alcohol is the slippery slope down to misuse.
The AHA points out that triglycerides and total cholesterol levels increase with heavy alcohol intake. A recent study shows that heart damage may be occurring with heavy alcohol use even before symptoms appear.
Although the question remains about whether or not alcohol can reduce heart disease risk, everyone agrees that too much alcohol harms the liver and increases the risk of dependence. It is important to consume alcohol only in moderation to achieve any potential cardiovascular benefit.
What Are The Health Risks Of Chronic Heavy Drinking
Alcohols adverse effects on blood pressure can also lead to other problems. For example, if you have hypertension and drink, youre at increased risk for a cardiovascular event, such as a heart attack or stroke. This risk is even higher if you dont have high blood pressure but have other risk factors for heart disease, such as diabetes or high cholesterol.
Alcohol also increases the risk for some types of cancer, including cancers of the mouth, throat, esophagus, and liver. In addition, alcohol can cause damage to the liver, which can lead to cirrhosis or even death.
If youre concerned about your alcohol consumption, talk to your doctor. They can help you assess your risk and make recommendations about lowering it.
If you have high blood pressure, its essential to be aware of the risks associated with chronic heavy drinking. Limiting your alcohol intake is one way to reduce those risks. Talk to your doctor about ways to manage your condition and lower your risk for chronic disease.
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Why Does Alcohol Cause Hypertension
Alcoholic beverages are regular drinks in most parts of the world. If consumed in little to moderate amounts, alcohol can be healthy for most individuals. However, drinking too much alcohol can create many problems including an increase in blood pressure. Having more than three drinks back-to-back can increase your blood pressure temporarily, but if you keep doing it frequently, you may develop a long-term condition called hypertension .
- Damage to the endothelium
- Increased calcium levels in the walls of the arteries
- Effect on hormones that constrict and relax the arteries
Heavy alcohol drinking increases blood pressure by about 5 to 10 mmHg and the increase in systolic pressure is more than that in diastolic blood pressure.
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Risk Of Bias In Included Studies
Refer to and for the overall ‘Risk of bias’ assessment.
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies.
We independently assessed risk of bias by following the methods described in Chapter 8 of the Cochrane Handbook for Systematic Reviews of Interventions . We assessed the risk of bias based on 11 domains: random sequence generation , allocation concealment , blinding of participants and personnel , blinding of outcome assessment , incomplete outcome data , selective reporting for systolic blood pressure , selective reporting for diastolic blood pressure , selective reporting for mean arterial blood pressure , selective reporting for heart rate , other bias , and other bias . We classified each domain as being at low, high, or uncertain risk of bias.
In the case of disagreement, a third party was involved to discuss and resolve the disagreement. In the case of uncertain information regarding the method of RCT, we contacted study authors via email to request clarification. Refer to for further details regarding reasons and responses.
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May Increase Cortisol Levels
Cortisol is the hormone that your body uses to regulate stress. It can dampen bodily functions not necessary to live in response to a fight-or-flight situation.
Studies have observed a connection between alcohol consumption and the increase of cortisol, which may be one reason people who are intoxicated tend toward aggression.
But it may also be one way that alcohol causes hypertension. However, it has also been observed that high cortisol levels are connected to heavy drinkers rather than moderate drinkers.
The Big Picture Of Heart Health
So what does the new study mean for your blood pressure and drinking preferences?
There are also other health risks to keep in mind.
Marcus said one that is underappreciated is the link between alcohol even moderate amounts and an increased risk of atrial fibrillation, a quivering or irregular heartbeat.
Moderate and even more so, heavy alcohol consumption is also linked to some types of
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How Much Alcohol Is Okay
It is okay to have drinks in moderation if you are a healthy individual. Here is what moderate alcohol consumption means.
For healthy men who are younger than 65 years old: Not more than two drinks per day
For healthy men who are 65 years of age and older: Not more than one drink per day
For healthy women of any age: Not more than one drink per day
Are There Any Blood Pressure Medications That Are Not Affected By Alcohol
Its important to remember alcohol has both direct and indirect effects on medications. Most blood pressure medications are not directly affected by alcohol. This means the alcohol does not change the physical properties of the medication. Alpha blockers, nondihydropyridine CCBs, and beta blockers are three classes of antihypertensives that can be directly affected by alcohol, which is why its dangerous to drink while taking them.
The bigger concern is alcohols indirect effects when it comes to hypertension and medications that treat it. Alcohol is known to raise blood pressure when consumed regularly and will make it harder for your medication to treat your condition. Over time, this puts you at a higher risk for heart attacks and strokes.
Because of alcohols indirect effects, there are no blood pressure medications that are risk-free when mixed with alcohol. Its important to discuss with your provider if theres a safe amount you can drink while taking your medications.
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How Does Alcohol Affect Your Blood Pressure
Drinking four drinks or more can increase your blood pressure short-term. If you binge drink , your blood pressure will be negatively impacted over the long-term.
That said, if you are a heavy drinker and you gradually cut your drinking back to moderate levels, youll benefit from a lower systolic blood pressure number . Your lower number should also drop. However, that doesnt mean you should try to stop drinking cold turkey. Doing so may lead to the development of severely high blood pressure, which can lead to other serious health issues.
If you already know you have hypertension, you should drink alcohol in moderation. Men younger than 65 can drink two drinks a day men older than 65 can have one drink a day women of any age can have one drink a day. One drink is 12 ounces of beer, 1.5 ounces of 80-proof distilled spirits, or 5 ounces of wine. You can find more thorough lists of what constitutes a drink if your drink of choice isnt listed here.
What About Moderate Drinking And Hypertension
Hypertension is the medical name for high blood pressure. As you may be aware, hypertension is a risk factor for heart attack and stroke.
Many people are under the impression that light or moderate alcohol intake may support heart health. They believe that heart rate will be lower and that the risk of heart disease is lowered for drinkers who have, for example, a glass or two of red wine each evening.
The fact is that even modest alcohol consumption can lead to an increased blood pressure. Over the long term, high blood pressure can lead to serious heart problems, including heart failure or even an irregular heartbeat.
While low level and moderate drinking can increase the risk of heart problems, and even cancer, excessive drinking is much worse. A heavy drinker has a much higher risk of developing alcohol induced hypertension.
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Does Excessive Drinking Contribute To Heart Disease
Heavy drinking, on the other hand, is linked to a number of poor health outcomes, including heart conditions. Excessive alcohol intake can lead to high blood pressure, heart failure or stroke. Excessive drinking can also contribute to cardiomyopathy, a disorder that affects the heart muscle.
Whats more, alcohol can contribute to obesity and the long list of health problems that can go along with it, McEvoy says: Alcohol is a source of excess calories and a cause of weight gain that can be harmful in the long term.
The takeaway, McEvoy says, is what you probably already knew: If you choose to drink alcohol, stick to moderate levels of drinking, and dont overdo it. Were not talking about going out and drinking yourself merry and then expecting good heart outcomes, McEvoy says.
Is Having 1 Or 2 Drinks Ok
Healthcare providers and pharmacists often get this question shortly before holidays or when a person is going to be attending a special event like a wedding.
Unfortunately, the research currently available focuses only on how binge drinking affects blood pressure medications. Whether or not its safe for you to have 1 or 2 drinks depends on which blood pressure medication you are taking. Therefore, you should always discuss this with your provider.
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Drink The Right Amount Of Water
When it comes to drinking water, the most common suggestion is eight 8-oz. glasses per day. However, as a more personal approach, divide your body weight by two, and aim to drink that amount in ounces daily.
For instance, a 200-pound person should consume about 100 ounces of water daily. Drinking a glass of water before taking a bath can also help flush toxins from the body and reduce blood pressure.
Potential Biases In The Review Process
We faced several limitations during the review process. First, there was the possibility of undesired bias and imprecision due to imputations of missing statistics. Most of the included studies did not report the standard error /standard deviation of the mean difference for the outcomes of interest. As described in our protocol, when we were unable to obtain the required SE/SD from study authors or by calculation from the reported P value or 95% CI, we imputed data according to the prespecified imputation hierarchy. We most often used the reported endpoint SE/SD value to impute the SE/SD of MD. This is known to provide a good approximation of the SD of change in BP so is unlikely to lead to bias. Also, only 10 out of 32 studies reported changes in MAP after alcohol consumption along with SE/SD . So, we had to calculate missing MAP values from reported SBP and DBP values using the formula mentioned in the protocol and we imputed the SE/SD for those.
We took several steps to minimise the risk of selection bias to identify eligible studies for inclusion in the review. We used highly sensitive search strategies. We also checked the lists of references in the included studies and articles that cited the included studies in Google Scholar to identify relevant articles. Furthermore, we contacted authors of included studies to obtain all relevant data when information was insufficient or missing.
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Alcohol: Does It Affect Blood Pressure
Medically reviewed by Drugs.com. Last updated on Jan 16, 2021.
Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks in one sitting temporarily raises your blood pressure, but repeated binge drinking can lead to long-term increases.
To understand how much alcohol is too much and how cutting back can lower your blood pressure, it may be helpful to know the definitions of excessive drinking.
- Binge drinking is defined as four or more drinks within two hours for women and five or more drinks within two hours for men.
- Moderate drinking is up to one drink a day for women, two for men.
- Heavy drinking is more than three drinks a day for women, four for men.
Heavy drinkers who cut back to moderate drinking can lower their top number in a blood pressure reading by about 5.5 millimeters of mercury and their bottom number by about 4 mm Hg.
If you have high blood pressure, avoid alcohol or drink alcohol only in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
A drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof distilled spirits.
Keep in mind that alcohol contains calories and may contribute to unwanted weight gain a risk factor for high blood pressure Also, alcohol can interact with certain blood pressure medications, affecting the level of the medication in your body or increasing side effects.
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Effects On Bp After Drinking
A study in the July 2020 Cochrane Database of Systematic Reviews sought to get a better handle on how, or if, drinking alcohol affects blood pressure and heart rate within a 24-hour period. Researchers culled data from 32 randomized controlled trials involving 767 participants.
According to the results, one glass of alcohol has little to no effect on blood pressure, and drinking one to two standard drinks decreases blood pressure for up to 12 hours. But for those who drank much more than two drinks, blood pressure started to rise after 12 hours, the review study found.
The Cochrane study suggests that blood pressure will be higher after a night of drinking among those who consume a high dose of alcohol. The effect of occasional drinking on blood pressure is likely reversible, but the study authors conclude that regular drinking of high amounts of alcohol can permanently affect your heart rate and impair baroreceptor sensitivity, which can result in hypertension .
This is why binge drinkers are more likely to have high blood pressure than their teetotaling counterparts, notes a June 2018 study in the Journal of the American Heart Association, which found that men especially had elevated BP after repeated binge drinking.
- 12 ounces of regular beer.
- 5 ounces of wine.
- 1.5 ounces of distilled spirits.
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