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Effect of alcohol on blood pressure
Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to ...
Cochrane Database Syst Rev. 2020 Jul; 2020(7): CD012787.
Published online 2020 Jul 1. doi: 10.1002/14651858.CD012787.pub2
PMCID: PMC8130994 PMID: 32609894
Effect of alcohol on blood pressure
Monitoring Editor: Cochrane Hypertension Group, Sara Tasnim, Chantel Tang, Vijaya M Musini, and James M Wright
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This article is an update of "Effect of alcohol on blood pressure" in volume 2017, CD012787.
This article has been cited by other articles in PMC.
Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to quantify the acute effects of different doses of alcohol over time on blood pressure and heart rate in an adult population.
To determine short‐term dose‐related effects of alcohol versus placebo on systolic blood pressure and diastolic blood pressure in healthy and hypertensive adults over 18 years of age.Secondary objective
To determine short‐term dose‐related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age.
The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2019: the Cochrane Hypertension Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), in the Cochrane Library; MEDLINE (from 1946); Embase (from 1974); the World Health Organization International Clinical Trials Registry Platform; and ClinicalTrials.gov. We also contacted authors of relevant articles regarding further published and unpublished work. These searches had no language restrictions.
Randomised controlled trials (RCTs) comparing effects of a single dose of alcohol versus placebo on blood pressure (BP) or heart rate (HR) in adults (≥ 18 years of age).
Data collection and analysis
Two review authors (ST and CT) independently extracted data and assessed the quality of included studies. We also contacted trial authors for missing or unclear information. Mean difference (MD) from placebo with 95% confidence interval (CI) was the outcome measure, and a fixed‐effect model was used to combine effect sizes across studies.
We included 32 RCTs involving 767 participants. Most of the study participants were male (N = 642) and were healthy. The mean age of participants was 33 years, and mean body weight was 78 kilograms.
Low‐dose alcohol (< 14 g) within six hours (2 RCTs, N = 28) did not affect BP but did increase HR by 5.1 bpm (95% CI 1.9 to 8.2) (moderate‐certainty evidence).
Medium‐dose alcohol (14 to 28 g) within six hours (10 RCTs, N = 149) decreased systolic blood pressure (SBP) by 5.6 mmHg (95% CI ‐8.3 to ‐3.0) and diastolic blood pressure (DBP) by 4.0 mmHg (95% CI ‐6.0 to ‐2.0) and increased HR by 4.6 bpm (95% CI 3.1 to 6.1) (moderate‐certainty evidence for all).
Medium‐dose alcohol within 7 to 12 hours (4 RCTs, N = 54) did not affect BP or HR.
Medium‐dose alcohol > 13 hours after consumption (4 RCTs, N = 66) did not affect BP or HR.
High‐dose alcohol (> 30 g) within six hours (16 RCTs, N = 418) decreased SBP by 3.5 mmHg (95% CI ‐6.0 to ‐1.0), decreased DBP by 1.9 mmHg (95% CI‐3.9 to 0.04), and increased HR by 5.8 bpm (95% CI 4.0 to 7.5). The certainty of evidence was moderate for SBP and HR, and was low for DBP.
High‐dose alcohol within 7 to 12 hours of consumption (3 RCTs, N = 54) decreased SBP by 3.7 mmHg (95% CI ‐7.0 to ‐0.5) and DBP by 1.7 mmHg (95% CI –4.6 to 1.8) and increased HR by 6.2 bpm (95% CI 3.0 to 9.3). The certainty of evidence was moderate for SBP and HR, and low for DBP.
High‐dose alcohol ≥ 13 hours after consumption (4 RCTs, N = 154) increased SBP by 3.7 mmHg (95% CI 2.3 to 5.1), DBP by 2.4 mmHg (95% CI 0.2 to 4.5), and HR by 2.7 bpm (95% CI 0.8 to 4.6) (moderate‐certainty evidence for all).
High‐dose alcohol has a biphasic effect on BP; it decreases BP up to 12 hours after consumption and increases BP > 13 hours after consumption. High‐dose alcohol increases HR at all times up to 24 hours. Findings of this review are relevant mainly to healthy males, as only small numbers of women were included in the included trials.
Plain language summaryAlcohol has a biphasic effect on blood pressure and increases heart rateReview question
We reviewed available evidence about the short‐term effects of different doses of alcoholic drinks compared to non‐alcoholic drinks on blood pressure and heart rate in adults (≥ 18 years) with both normal and raised blood pressure.Background
Drinking excessive alcohol is considered one of the most common causes of raised blood pressure. We wanted to quantify the effects of a single dose of alcohol on blood pressure and heart rate within 24 hours of consumption.Study characteristics
We included 32 randomised controlled trials involving 767 participants published up to March 2019. Although these trials included adults from 18 to 96 years of age with various health conditions, most study participants were young healthy males. The source of funding was not reported for a majority of the studies.
How alcohol affects blood pressure and the heart
Drinking too much alcohol can cause high blood pressure and damage your heart. Find out how you can reduce your risk of high blood pressure at HSE.ie.
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1. Blood pressure and the heart
A lot of alcohol over a long time - or too much on a single occasion - can damage the heart or interfere with the way it works.
This can cause different problems, including:
high blood pressure (hypertension)
increased risk of strokes
cardiomyopathy (stretching and drooping of the heart muscle)
arrhythmias (irregular heartbeat)
High blood pressure (hypertension)
High blood pressure is the most common alcohol-related health problem. Many people don’t realise they have it.
Drinking a lot of alcohol can affect the muscles in your blood vessels. This can cause them to become narrower.
The more alcohol you drink the higher the risk of developing hypertension. If you drink regularly you are at risk, especially if you’re over the age of 35. One drink a day can increase the risk.
When your blood vessels are narrower, the heart has to work harder to push blood around your body. This makes your blood pressure go up.
High blood pressure can significantly increase your risk of:
stroke heart disease
vascular dementia - caused by not enough blood being able to get to the brain
chronic kidney disease
Weekly low-risk alcohol guidelines
Reduce your risk of hypertension
Hypertension is one of the most preventable alcohol-related problems. Drinking less alcohol lowers your blood pressure.
Reducing the amount you drink can help you lose weight. This is also good for heart health.
Hypertension causes most problems when it’s left untreated. Get your blood pressure checked regularly so that you can get treatment if you need it.
Your GP or pharmacist can check your blood pressure.
A stroke happens when blood cannot reach the brain.
Binge drinking and long-term heavy drinking can lead to strokes.
Alcohol also causes other problems that can lead to strokes, or makes them worse. For example, high blood pressure, irregular heartbeat, and weakened heart muscle.
Stretching and drooping of the heart muscle ( cardiomyopathy)
Long-term heavy drinking can cause the heart muscles to weaken. This is called alcoholic cardiomyopathy.
If your heart muscle is droopy and stretched it can’t pump blood around your body very well. If the blood flow to other parts of your body is not enough, it can damage organs and tissues.
It can also cause symptoms like:
swollen legs and feet
irregular heartbeat heart failure
Irregular heart beat (arrhythmias)
Binge drinking and long-term high-risk drinking can affect how quick your heart beats.
Alcohol can make the heart beat too quickly, or irregularly. These heart rate abnormalities are called arrhythmias.
Page Last Reviewed: 08/11/2019
Next Review Due: 08/11/2022
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Alcohol and blood pressure
Alcohol can contribute to high blood pressure, which can lead to serious heart conditions. Get the facts with Drinkaware
Alcohol and blood pressure
Alcohol can have a serious long-term effect on blood pressureDrinking alcohol increases blood pressure and repeated drinking causes sustained high blood pressure.
Alcohol consumption is an entirely preventable cause of severe hypertension (the medical name for sustained high blood pressure) in both men and women.1 Untreated high blood pressure greatly increases your risk of stroke and heart attack.2
What is high blood pressure?
A normal heart pumps blood around the body easily, at a low pressure. Having high blood pressure means that your heart must pump harder, and the arteries have to carry blood that’s flowing under greater pressure. This puts a strain on your arteries and your heart, which in turn increases your risk of a heart attack, a stroke or of suffering from kidney disease.
What are the symptoms of high blood pressure?
You can't usually feel or notice high blood pressure. In fact, many people may not know they have it. This is because high blood pressure very rarely causes any obvious symptoms until a serious acute event such as a heart attack or stroke.
The best way of knowing if there’s a problem is to have your blood pressure measured. You can have this done at your GP surgery, some local pharmacies, at your NHS Health Check or you can buy a reliable blood pressure monitor from the pharmacist.
Are you drinking too much? Take our self-assessment
What causes high blood pressure?
There isn’t always a clear explanation as to why someone’s blood pressure is high. However, there are several factors that can play a part in increasing the risks of developing hypertension, including:
Regularly drinking alcohol above the low-risk guidelines
Not doing enough exercise
A family history of high blood pressure
Consuming too much salt
How to reduce high blood pressure
To lower your blood pressure, you should:
Cut down on alcohol Exercise regularly
Lose weight, if you are overweight
Eat a healthy diet, including reducing your salt intake
How to reduce your drinking
The UK Chief Medical Officers' (CMO) low risk drinking guidelines advise that people should not regularly drink more than more than 14 units a week to keep health risks from alcohol low. If you do choose to drink, it is best to spread your drinks throughout the week.
Keep track of what you’re drinking
Our free MyDrinkaware app can tell you if you're drinking too much. It can even help you cut down.
Download the app
Switch to non-alcoholic or low alcohol options
Have several drink-free days a week
If you’re worried about your blood pressure, talk to a health professional at your GP surgery. Or if you’re looking for more information, Blood Pressure UK offers a range of advice on how to take control of, or prevent, high blood pressure. Call their information line on 020 7882 6218 or visit www.bloodpressureuk.org
High blood pressure increases the risk of heart problems, stroke, and kidney disease. More information on these issues is available from the following organisations:
British Heart Foundation
The Stroke Association
Kidney Research UK
Further advice and informationArming yourself with strategies and tips can help you or a loved one take small steps towards big results.
How to stay motivated while cutting down on alcohol
How to cut down on alcohol at home
What to expect when you stop drinking
Alcohol and heart disease
Was this information helpful?Last Reviewed: 27th October 2021Next Review due: 27th October 2024