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To Drink or Not to Drink: High Blood Pressure and Alcohol

Does a glass a day keep high blood pressure away? Get the facts before your next pour.
By Jenn Horton
WebMD Feature

Some research shows that drinking alcohol in moderation makes for a healthier heart. But is drinking risky or good for your blood pressure? Weigh the pros and cons to help you make the smart choice.

Is Alcohol Good for High Blood Pressure?

It likely depends a lot on what else is going on with you.

First things first: Your best bets for lowering blood pressure are losing weight through diet and exercise, cutting sodium intake, and reducing stress.

But what if you enjoy a drink or two now and then? Light-moderate drinking (defined as up to two drinks a day for men, one for women) has shown a subtle drop in blood pressure in some cases. In small amounts, it has been shown to lower blood pressure by 2 to 4 mm Hg (millimeters of mercury) in women. Most experts agree, though, that does not show a significant enough drop to advise drinking for an entire population.

But what about those other benefits hailed for heart health -- the red wine antioxidant effect and lowering cholesterol, for example?

You need to determine your lifestyle and genetic risk factors first, says Arthur Klatsky, MD, an investigator for Kaiser Permanente's research division and formerly its chief of cardiology in Oakland, CA.

A lot of people shouldn’t drink at all for specific reasons -- family history of alcoholism or heart or liver disease, he says. But if you have no hereditary risk factors, a glass (for women) or up to two (for men) may be justified, depending on your age.

“Adults above the age of 50 are at much higher risk of heart attack and stroke than they are of any possible harmful effects to light-moderate drinking,” Klatsky says. “So even if they have high blood pressure, they could see the health benefit from something like a glass of red wine a day."

But if you're younger than 50, particularly if you're a woman, it’s not so clear. Studies have shown a rise in breast cancer risk in women under 50 from drinking alcohol. While most studies show this results from drinking more heavily (more than 1-2 drinks a day), Klatsky says some research indicates even light-moderate drinking could play a role in a younger woman’s risk of breast cancer.

“Generally a woman 35 or younger isn’t dealing with blood pressure or vascular issues,” Klatsky says. “But I would still advise against her drinking at all because of the other risks involved. The general rule is that young people are not better off light-moderate drinkers because their heart attack risk is pretty low and won’t see any benefits from drinking.”

The bottom line, Klatsky says, is you can’t make a drinking rule that applies broadly for people with high blood pressure.

“There can be benefits related to light-moderate drinking -- like the antioxidant effect and cholesterol drop with red wine -- but likely that’s not related to blood pressure,” Klatsky says. “Either beneficial or harmful, the decision from a medical viewpoint is that it depends on the person’s entire health profile.”

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