Understanding the Connection Between Alcohol and Blood Pressure

High blood pressure (BP) forces your heart to work extra hard to pump blood, causing your arteries to become stiff and narrow over time, setting the stage for a heart attack or stroke, notes the American Heart Association (AHA). And when it comes to drinking's effect on BP, moderation is key.

What's high BP? The AHA defines hypertension as a consistently elevated high systolic (upper) pressure of 130 or higher, or a diastolic (lower) pressure of 80 or higher.

Read more: High Blood Pressure: What's Considered Dangerous?

A study in the July 2020 ​Cochrane Database of Systematic Reviews​ sought to get a better handle on how, or if, drinking alcohol affects blood pressure and heart rate within a 24-hour period. Researchers culled data from 32 randomized controlled trials involving 767 participants.

According to the results, one glass of alcohol has little to no effect on blood pressure, and drinking one to two standard drinks decreases blood pressure for up to 12 hours. But for those who drank much more than two drinks, blood pressure started to rise after 12 hours, the review study found.

The ​Cochrane​ study suggests that blood pressure will be higher after a night of drinking among those who consume a high dose of alcohol. The effect of occasional drinking on blood pressure is likely reversible, but the study authors conclude that regular drinking of high amounts of alcohol can permanently affect your heart rate and impair baroreceptor sensitivity, which can result in hypertension (aka high blood pressure).

The baroreceptor reflex helps your body maintain normal blood pressure levels, as a November 2016 review article in the ​Nursing Times​ explains.

This is why binge drinkers are more likely to have high blood pressure than their teetotaling counterparts, notes a June 2018 study in the ​Journal of the American Heart Association​, which found that men especially had elevated BP after repeated binge drinking.

How do you measure one glass of alcohol? According to the National Institute on Alcohol Abuse and Alcoholism, one standard drink is:

• 12 ounces of regular beer.
• 5 ounces of wine.
• 1.5 ounces of distilled spirits.

Alcohol can also make your heart beat faster, regardless of how much alcohol you consume, says Guy L. Mintz, MD, director of cardiovascular health and lipidology at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, New York. Your heart rate, or pulse, is the number of times your heart beats per minute. Elevated heart rate may travel with elevated blood pressure, he says.

This increase in heart rate can also lead to "holiday heart syndrome," Dr. Mintz says. "In the 24 to 48 hours after you drink, you can experience irregular heartbeats." This was first noticed in emergency rooms after New Year's Eve, a night known for celebratory — and sometimes excessive — alcohol consumption.

There are other ways that drinking can affect your heart. "It has calories, and calories can cause weight gain and obesity, which will lead to high blood pressure," Dr. Mintz says.

To lower any risks associated with overdoing it, the AHA suggests limiting your alcohol consumption to no more than:

• 2 drinks a day for men.
• 1 drink a day for women.

This is considered moderate alcohol intake. And what you drink matters. "Wine and spirits like whiskey or vodka are OK," Dr. Mintz says. "Anything but beer is OK, as beer comes with a salt load that can cause high blood pressure and is high in calories."

According to the ​Dietary Guidelines for Americans 2020-2025​, not everyone should consume alcohol. Individuals taking certain medications or who have underlying medical conditions or a history of alcoholism should not drink alcohol — even in moderate amounts. Dr. Mintz advises that people talk to their doctor about alcohol intake and how it may affect their overall health.

​Read more:​ Alcohol Boasts Some Benefits — but Only if You Drink It the Right Way