Even moderate alcohol use increases risk of high blood pressure, new meta-analysis confirms
Drinking alcohol on a regular basis is associated with a heightened risk of hypertension, according to a new meta-analysis published in Hypertension.[1]
“Alcohol consumption has been associated with a variety of cardiovascular disease outcomes, including cardiomyopathies, coronary artery disease, stroke and increased blood pressure, the latter endpoint of blood pressure having been recently reviewed through a dose-response meta-analysis,” wrote first author Marta Cecchini, a researcher with the University of Modena and Reggio Emilia in Italy, and colleagues. “However, uncertainties exist regarding its association with the risk of hard outcomes including hypertension, particularly at low levels of alcohol intake and whether sex and race modify the association.”
Cecchini et al. explored data from 23 different studies originally published between 1990 and 2023. While eight of those studies were conducted in the United States, the others occurred in China, Japan, South Korea, the United Kingdom, Spain and Finland. Follow-up periods ranged from two to 22 years. Hypertension was typically defined as an average systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg or treatment with an antihypertensive medication. Alcohol consumption was measured in terms of grams per day (g/d).
Overall, the team’s analysis revealed a “positive and almost linear association” between alcohol consumption and hypertension. Risk ratios were 0.89 for individuals who drank no alcohol, 1.11 for those who drank at least 24 g/d, 1.22 for those who drank at least 36 g/d and 1.33 for those who drank at least 48 g/d. This was seen in both sexes, but women who drank smaller amounts of alcohol seemed to see their hypertension risk increase less than it did in men. In addition, hypertension risks appeared to rise more dramatically in white participants than they did in Black participants.
“Based on our analysis, a moderate to high usual intake of alcohol seems to be a risk factor for hypertension in both men and women, with a stepper slope in women,” the group wrote. “In contrast, at low levels of alcohol intake, an increased risk of hypertension may only apply in men.”
What, exactly, leads to this close relationship between alcohol use and hypertension? The authors presented some possible explanations.
“There is biological plausibility for the determinantal effect of alcohol on the risk of hypertension,” they wrote. “One potential mechanism for an alcohol effect on blood pressure and risk of hypertension is stimulation of the renin-angiotensin-aldosterone system with a resultant increase in angiotensin II and plasma cortisol levels. Additional possibilities are sympathetic nervous system stimulation due to increases in noradrenaline levels, decrease of baroreceptor sensitivity and an increase of intra-cellular calcium leading to blood vessel constriction. Hormonal factors might also explain the different associations between alcohol intake and the risk of hypertension in men and women, particularly at low levels of intake, given the relevance of ovarian hormones and of testosterone in blood pressure regulation.”
Click here to read the full analysis in Hypertension, an American Heart Association journal.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.