Does Alcohol Raise Your Blood Pressure? What You Need to Know

Many people enjoy an alcoholic beverage or two to unwind after a long day or to celebrate the weekend. In fact, alcohol use is on the rise in the U.S. and worldwide.

But regular alcohol use is closely linked to various health issues — including high blood pressure (also called HBP or hypertension). Along with a high-salt diet and smoking, alcohol is one of the most common preventable causes of HBP. 

If you already have HBP, consuming alcohol regularly may worsen your condition and interact with your HBP medications.

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• Is red wine good for heart health? The answer isn’t so clear. Here’s what researchers say about a direct link between red wine and lower cardiovascular risk.

How does alcohol affect my blood pressure?

It depends on how much — and how often — you drink. Several studies show that low doses of alcohol (one drink) don’t affect blood pressure in the short term. But binge drinking — defined as having 5 or more drinks for men and 4 or more drinks for women within the span of 2 hours — can cause a temporary spike in blood pressure. 

Alcohol can lower blood pressure in some people. But this effect is almost always temporary. The blood pressure-lowering effect of alcohol is due to a release of several substances, such as nitric oxide (NO). This causes blood vessels to widen, which lowers blood pressure. But these substances don’t stick around for long. About 12 hours after your last drink, blood pressure can rise, especially if a large amount of alcohol was consumed.

Those who drink heavily and regularly can develop chronic high blood pressure (hypertension). This means that blood pressure doesn’t return to normal between drinking episodes. Moderate drinkers (7 to 13 drinks per week) are twice as likely as non-drinkers to develop hypertension. And people with diabetes who drink heavily (more than 15 drinks per week) are 3 times as likely to develop high blood pressure.

How much does alcohol raise your blood pressure? 

Healthcare professionals look at three aspects of blood pressure. This includes your systolic and diastolic blood pressure (the top and bottom numbers). It also includes your mean arterial pressure (the average pressure in your arteries during a heartbeat). Over time, alcohol can increase all three numbers, raising your risk for cardiovascular disease.

A recent study found that blood pressure increases with ongoing alcohol use. Over time, the more a person drinks, the higher their blood pressure. Researchers found that alcohol can raise blood pressure by up to 10 mmHg when consuming three drinks per day. 

Why does alcohol raise blood pressure?

Blood pressure may temporarily go down after an alcoholic drink. But the overall long-term effect of regular drinking is a gradual rise in blood pressure. This is because of alcohol’s impact on several different parts of your body, including your nervous system, kidneys, and blood vessels. 

HBP is caused by the alcohol’s effects on these body systems and hormones:

• Your brain and sympathetic nervous system release fight-or-flight hormones like adrenaline. This raises blood pressure and heart rate.

• Calcium levels rise in response to drinking alcohol. This can cause blood vessels to narrow and blood pressure to go up.

• Vasopressin is a naturally occurring chemical that increases after drinking. It causes your body to hold on to more water, which raises blood pressure.

• Renin-angiotensin-aldosterone levels increase, leading to narrowed blood vessels and elevated blood pressure.

• Cortisol, a stress hormone, causes water retention and a rise in blood pressure.

• Baroreceptors, sensors in blood vessels, respond to regular alcohol use by increasing blood pressure.

In addition to these direct effects on blood pressure, alcohol also indirectly increases the risk of high blood pressure. Alcoholic drinks are often high in calories and sugar, contributing to weight gain and diabetes. Larger body sizes and diabetes go hand in hand with high blood pressure. 

Will quitting alcohol lower blood pressure?

Yes. Limiting or quitting alcohol altogether is one of the best ways to safely lower your blood pressure over time. 

One study showed that people who had two or more drinks per day significantly improved their blood pressure readings by lowering their alcohol intake. If your alcohol intake decreases from heavy to moderate, you can expect to lower your systolic blood pressure by 5.5 mmHg and your diastolic blood pressure by 4 mmHg. If you quit altogether, you may be able to lower your blood pressure even more. 

As a general rule, limit your alcohol intake to no more than one to two drinks per day to help improve your blood pressure. Drinking more than average — more than one drink per day for women and two drinks per day for men — can cause your blood pressure to rise.

Is red wine good for my heart and blood pressure?

Some studies — frequently featured in the news — suggest that a glass of red wine a day is good for your heart. But how true is that, really?

Some research has shown an association between drinking red wine, beer, and spirits and better health. Some possible reasons these alcoholic drinks may improve heart and blood vessel health include:

• Raising high-density lipoprotein (HDL) cholesterol (“good” cholesterol)

• Lowering low-density lipoprotein (LDL) cholesterol (“bad” cholesterol)

• Preventing blood-clotting cells called platelets from becoming too “sticky”

• Increasing NO levels and lowering diastolic blood pressure, especially in those with Type 2 diabetes

But many studies that suggested alcohol was healthy had complicating factors. For example, older European men and women who drank regularly and moderately had improved survival rates. But they also ate a Mediterranean diet, which is considered healthier than the standard diet in the U.S. While a few studies show that red wine might lower blood pressure in some people, others show that it can actually increase blood pressure.

In these cases, it’s not likely that alcohol alone led to better health. Healthy habits, like a balanced diet and an active lifestyle, probably made the biggest difference.

Can alcohol affect my blood pressure medications?

If you’re already taking medications to treat HBP, you should be especially mindful of your alcohol intake. This isn’t just because of alcohol’s effects on your blood pressure but also because of how it might interact with your medications.

Most blood pressure medications come with the possible side effect of low blood pressure (hypotension). This can result in dizziness — especially when going from lying or sitting to standing (called orthostatic hypotension). This side effect, combined with the low blood pressure and balance issues caused by alcohol, can put you at a higher risk for falls and accidents. 

Some classes of blood pressure medications have a higher risk of interacting dangerously with alcohol than others, including:

• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), such as lisinopril or valsartan

• Alpha blockers, like clonidine or prazosin

• Beta blockers, like metoprolol or carvedilol

• Nitrates, like nitroglycerin or isosorbide mononitrate

If you take any of these medications and want to know if and when it’s safe to drink alcohol, be sure to discuss this with a healthcare professional. Remember — it’s never a good idea to stop or skip doses of your medications just because you’re planning to have a few drinks.

Is there a safe amount of alcohol to drink when it comes to blood pressure?

According to the American Heart Association, women should limit their alcohol intake to no more than one drink per day, while men should limit it to no more than two drinks per day. These guidelines also apply if you have high blood pressure. 

One drink is equivalent to:

• 12 oz of beer

• 4 oz of wine

• 1.5 oz of 80-proof alcohol

• 1 oz of 100-proof alcohol

Healthcare professionals generally recommend avoiding alcohol if you take certain medications — including the blood pressure medications discussed above. If you have questions about how much alcohol is safe to drink in your situation, be sure to ask your primary care provider. 

If you struggle with alcohol use disorder or addiction, discuss this with your healthcare team. They can help you come up with a treatment plan that’s right for you. 

What is the worst alcohol for high blood pressure?

A recently published study looked at over 100,000 adults and found that all types of alcohol caused similar and significant increases in blood pressure (both systolic and diastolic). This includes red wine, white wine, spirits, and beer. The study found that the more a person drinks, the higher their blood pressure. This means that the total amount of alcohol consumed seems to be a better predictor of high blood pressure than the type of alcohol consumed. 

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Written by:

Alice Perlowski, MD, MA, FACC

Dr. Alice Perlowski is a board-certified cardiologist and fellow of the American College of Cardiology. She has seen patients and supervised trainees in the academic and private sector, with focuses in interventional cardiology, vascular medicine, preventative cardiology, and women’s heart health.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

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