Routinely drinking alcohol may raise blood pressure even in adults without hypertension

Research Highlights:

• An analysis of data from seven studies involving more than 19,000 adults in the United States, Korea and Japan found a clear association between increases in systolic (top-number) blood pressure and the number of alcoholic beverages consumed daily.
• Even people who drank one alcoholic beverage per day showed a link to higher blood pressure when compared to non-drinkers, reinforcing the American Heart Association’s advice to limit alcohol intake and to not start drinking alcohol if you do not already.

Newswise — DALLAS, July 31, 2023 —An analysis of seven international research studies published in Hypertension, an American Heart Association journal, reveals that even in adults without hypertension, blood pressure readings may increase more rapidly over time with an increase in the number of daily alcoholic drinks.

For the first time, this analysis, combining the statistical power of seven international research studies, confirms a continuous rise in blood pressure measures in both individuals with low and high alcohol intake. Notably, even low levels of alcohol consumption were linked to detectable increases in blood pressure levels, potentially raising the risk of cardiovascular events.

According to senior study author Marco Vinceti, M.D., Ph.D., a professor of epidemiology and public health at the Medical School of the University of Modena and Reggio Emilia University in Italy, and an adjunct professor in the department of epidemiology at Boston University’s School of Public Health, their research revealed no beneficial effects in adults who consumed a low level of alcohol compared to those who abstained from alcohol altogether. Surprisingly, even consuming an already-low level of alcohol was associated with higher blood pressure changes over time, though significantly less than the blood pressure increase observed in heavy drinkers.

Study co-author Tommaso Filippini, M.D., Ph.D., an associate professor of epidemiology and public health at the Medical School of the University of Modena and Reggio Emilia in Italy, and an affiliate researcher at the University of California Berkeley School of Public Health, explained that their analysis focused on grams of alcohol consumed rather than simply the number of drinks. This approach was adopted to prevent biases that could arise from variations in the amount of alcohol present in 'standard drinks' across different countries and types of beverages.

After reviewing the health data of participants from the seven studies over a span of more than five years, researchers made comparisons between regular alcohol drinkers and non-drinkers, leading to the following findings:

1. In individuals who consumed an average of 12 grams of alcohol per day, systolic (top number) blood pressure increased by 1.25 millimeters of mercury (mm Hg), while it rose to 4.9 mm Hg in those consuming an average of 48 grams of alcohol per day. (In the U.S., approximately 12 ounces of regular beer, 5 ounces of wine, or a 1.5-ounce shot of distilled spirits contains about 14 grams of alcohol. The alcohol content may vary in alcoholic beverages available in other countries.)
2. For diastolic (bottom number) blood pressure, an average of 12 grams of alcohol per day led to a rise of 1.14 mm Hg, while it increased to 3.1 mm Hg in those consuming an average of 48 grams of alcohol per day. Notably, these associations were observed in males but not in females. Diastolic blood pressure measures the force against artery walls between heartbeats and is considered less strong in predicting the risk of heart disease compared to systolic blood pressure.

According to Vinceti, while alcohol is not the sole factor responsible for elevated blood pressure, their findings unequivocally establish its significant contribution. He advises limiting alcohol intake, and ideally, avoiding it altogether for better health outcomes.

It's worth noting that although none of the participants had high blood pressure at the outset of the studies, their initial blood pressure measurements did influence the observed associations with alcohol consumption.

According to study co-author Paul K. Whelton, M.D., M.Sc., the Show Chwan Chair in Global Public Health in the department of epidemiology at Tulane University’s School of Public Health and Tropical Medicine in New Orleans, and president of the World Hypertension League, their research uncovered a notable correlation between alcohol intake and blood pressure changes over time, particularly in participants with higher baseline blood pressure readings. This indicates that individuals with a tendency toward increased (though not yet "high") blood pressure may derive the greatest benefit from reducing their alcohol consumption to low or no levels. Notably, Whelton also serves as the chair of the American Heart Association's 2017 Hypertension Practice Guidelines and is a member of the writing committee for the Association's 2021 Scientific Statement on Management of Stage 1 Hypertension in Adults.

As per the guidelines set forth by the American Heart Association, if you are a non-drinker, it is advised not to initiate alcohol consumption. However, if you already consume alcohol, it is essential to consult with your doctor to discuss the potential benefits and risks of moderate alcohol consumption. The Association explicitly discourages drinking alcohol for the sake of potential health benefits.

Instead, the American Heart Association recommends adhering to their "Life's Essential 8" principles for achieving optimal cardiovascular health. These guidelines encompass the following: maintaining a healthy diet, engaging in regular physical activity, refraining from smoking, ensuring sufficient sleep, managing a healthy weight, and controlling cholesterol, blood sugar, and blood pressure levels. Embracing these lifestyle and health metrics can contribute significantly to promoting heart health.

Study Details and Background:

1. In this research, data from seven large observational studies involving 19,548 adults (65% men) were carefully examined. The participants' ages ranged from 20 to their early 70s at the commencement of the studies. These studies were conducted in the United States, Korea, and Japan, and their publication dates spanned from 1997 to 2021. Importantly, none of the participants had a prior diagnosis of high blood pressure, cardiovascular diseases, diabetes, liver disease, alcoholism, or a history of binge drinking.
2. At the beginning of each study, the researchers recorded the participants' usual alcoholic beverage intake, which was then converted into the typical number of grams of alcohol consumed per day. To analyze the data effectively, the researchers employed a novel statistical technique, allowing them to combine results from multiple studies and plot a curve representing the impact of varying alcohol consumption on changes in blood pressure over time.
3. Systolic blood pressure, which represents the top number in a blood pressure reading, reflects the force exerted against artery walls when the heart contracts. As individuals age, systolic blood pressure tends to increase steadily and serves as a robust predictor of cardiovascular disease risk. Given its significance, effective blood pressure management is crucial to reduce, prevent, or delay the development of high blood pressure.

The manuscript includes a list of other co-authors and authors' disclosures.

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