No Beneficial Effects of Alcohol
"We found no beneficial effects in adults who drank a low level of alcohol compared to those who did not drink alcohol," said senior study author Marco Vinceti, M.D., Ph.D., a professor of epidemiology and public health in 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.
"We were somewhat surprised to see that consuming an already-low level of alcohol was also linked to higher blood pressure changes over time compared to no consumption -- although far less than the blood pressure increase seen in heavy drinkers," Vinceti said.
"Our analysis was based on grams of alcohol consumed and not just on the number of drinks to avoid the bias that might arise from the different amount of alcohol contained in "standard drinks" across countries and/or types of beverages," said study co-author Tommaso Filippini, M.D., Ph.D., an associate professor of epidemiology and public health in the Medical School of the University of Modena and Reggio Emilia in Italy, and affiliate researcher at the University of California Berkeley School of Public Health.
Drinkers and Non-Drinkers Compared
Researchers reviewed the health data for all participants across the seven studies for more than five years. They compared adults who drank alcohol regularly with non-drinkers and found:
- Systolic (top number) blood pressure rose 1.25 millimeters of mercury (mm Hg) in people who consumed an average of 12 grams of alcohol per day, rising to 4.9 mm Hg in people consuming an average of 48 grams of alcohol per day. (In the U.S., 12 ounces of regular beer, 5 ounces of wine or a 1.5 ounce shot of distilled spirits contains about 14 grams of alcohol. Usual alcohol content differs in alcohol available in other countries.)
- Diastolic (bottom number) blood pressure rose 1.14 mm Hg in people consuming an average of 12 grams of alcohol per day, rising to 3.1 mm Hg in people consuming an average of 48 grams of alcohol per day. These associations were seen in males but not in females. Diastolic blood pressure measures the force against artery walls between heartbeats and is not as strong a predictor of heart disease risk in comparison to systolic.
"Alcohol is certainly not the sole driver of increases in blood pressure; however, our findings confirm it contributes in a meaningful way. Limiting alcohol intake is advised, and avoiding it is even better," Vinceti said.
Although none of the participants had high blood pressure when they enrolled in the studies, their blood pressure measurements at the beginning did have an impact on the alcohol findings.
A Trend Toward High Blood Pressure
"We found participants with higher starting blood pressure readings, had a stronger link between alcohol intake and blood pressure changes over time. This suggests that people with a trend towards increased (although still not "high") blood pressure may benefit the most from low to no alcohol consumption," said 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.
Whelton is also the chair of the American Heart Association"'s 2017 Hypertension Practice Guidelines and a member of the writing committee for the Association's 2021 Scientific Statement on Management of Stage 1 Hypertension in Adults.
If You Don't Drink, Don't Start
According to American Heart Association recommendations, if you don't drink already, don't start. If you do drink, talk with your doctor about the benefits and risks of consuming alcohol in moderation.
The Association also does not recommend drinking any form of alcohol to gain potential health benefits. Instead, follow the Association's lifestyle and health metrics for optimal cardiovascular health called Life's Essential 8: eat healthy food, be physically active, don't smoke, get enough sleep, maintain a healthy weight, and control cholesterol, blood sugar and blood pressure levels.
Source: Federico, SD, et al. "Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies." Hypertension. 31 July 2023.