Alcohol: Does it affect blood pressure?

An increase in sympathetic activity is consistent with impairment of the baroreceptors that, when activated, inhibit the sympathetic nervous system[45,47]. A recent study shows the least mortality at 100 g/week or less of alcohol, with a dose-dependent relationship between alcohol and stroke, IHD, fatal hypertensive disease, heart failure, and fatal aortic aneurysm. Notably, the heart attack risk was in inverse relation to alcohol consumption levels. The evidence synthesised in this review was collected from 32 RCTs in 767 participants. Of the 32 studies, two studied low‐dose alcohol, 12 studied medium‐dose alcohol, and 19 studied high‐dose alcohol.

Only four studies included almost equal numbers of male and female participants (Buckman 2015; Foppa 2002; Maufrais 2017; Zeichner 1985). As a result, we were not able to quantify the magnitude of the effects of alcohol on men and women separately. This is unfortunate, as we have reason to believe that the effects of alcohol on BP might be greater in women.

Bailey 1989 published data only

Even though these studies reported that participants were randomised to receive alcohol or placebo, the method of randomisation was not mentioned. Although three studies did not report the method of randomisation (Barden 2013; Buckman 2015; Dai 2002), their reported baseline characteristics were well matched. The remaining seven studies reported the method of randomisation used, hence we classified them as having low risk of bias. It is important to note that information regarding to the method of randomisation used in Foppa 2002 and Rosito 1999 was provided by the study author via email. Both reviewers (ST and CT) rated the certainty of evidence independently by examining risk of bias, indirectness, inconsistency, imprecision, and publication bias.

“Alcohol consumption might affect left ventricular diastolic properties, even in nonalcoholic patients,” say the researchers. Moreover, not only does drinking cause elevated blood pressure, but in excess, it can directly enhance the damage caused to cardiac and renal tissues by hypertension. Some scientists suggest a J-shaped curve between alcohol and CVD, but this remains a hypothesis. Hypertension is rising in prevalence due to the rising mean age of the population as well as due to the increased prevalence of poor dietary patterns and other lifestyle factors. Therefore, potential interventions could target weight loss, a sedentary lifestyle, appropriate sodium/potassium intake changes, smoking, and excessive alcohol intake.

Avellone 2006b published data only

Not surprisingly, alcohol consumption has complex and varying effects on platelet function. On the other hand, significant daily alcohol consumption increases platelet aggregation and reactivity. Infection or other stressful events also can lead to immune-triggered platelet production, a condition called rebound thrombocytosis, which may occur immediately after withdrawal from both heavy and one-time heavy (binge) drinking (Numminen et al. 1996). Although highly individualized and dose dependent, alcohol use also can increase bleeding time (i.e., taking longer to develop a clot)(Salem and Laposata 2005). Imbalance of specific endogenous vasoconstrictor such as angiotensin II, endothelin-1 and nor-epinephrine and vasodilator nitric oxide (NO) may also play an important role in alcohol-induced hypertension.

CUnclear risk of selection bias and attrition bias in more than one study. AUnclear risk of selection bias and attrition bias in more than one study. Refer to Characteristics of included studies and Table 4 for further details regarding these studies. We conducted a standard does alcohol affect bp Chi² test through Review Manager Software 5.3 to test for heterogeneity (Review Manager (RevMan)). A P value of 0.1 or less was considered to show statistically significant heterogeneity. The I² statistic was used to interpret the level of heterogeneity (Higgins 2011).

Okamura 2001 published data only

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. If you have high blood pressure, it’s important to discuss any risk factors with your healthcare provider, including alcohol consumption.

• To determine short‐term dose‐related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age.
• Most often, low-risk or moderate drinking has been defined as 1 to 2 standard drinks per day and heavy alcohol consumption as 4 or more standard drinks per day.
• This systematic review searched only the MEDLINE database for relevant studies, hence it was not exhaustive.
• Alcohol can affect drinkers differently based on their age, sex, ethnicity, family history, and liver condition (Cederbaum 2012; Chen 1999; Gentry 2000; Thomasson 1995).
• These effects can happen even after one drink — and increase with every drink you have, states Dr. Anand.