One Drink Per Day Linked with Increased Blood Pressure in Healthy Adults

The popularity of new non-alcoholic beer and mocktails couldn’t have come at a better time. New research finds that consuming just one alcoholic drink a day may raise blood pressure in healthy adults. This is based on a dose-response meta-analysis. The burning question is if regular intake of small amounts of alcohol is linked with a higher level of blood pressure.

According to study co-author Paul Whelton, MD, with Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, “We identified a continuous, more or less linear association, with no evidence of a threshold for the association."

Whelton found that for systolic blood pressure, the most important risk factor for CVD, the link was observed in both men and women in North America and Asia. Based on the study results, less alcohol is better and no alcohol is best. He notes they didn’t find any indication that even small amounts of alcohol are beneficial to health.

Senior author Marco Vinceti, MD, PhD, with the University of Modena and Reggio Emilia University in Italy states, “Clearly, alcohol is not the only or necessarily the main determinant of high blood pressure, and the effects of small intakes of alcohol emerging from our pooled analysis were certainly not biologically as relevant and meaningful as those induced by high intakes."

Data from seven large, observational studies done in the US, Korea, and Japan which included 19,548 adults (65% men) was used. Subjects were aged 20 to the early 70s at the study’s start and were followed for an average of 5.3 years.

The subjects were not diagnosed with high blood pressure, CVD, diabetes, liver disease, alcoholism, or binge drinking previously.

When compared to those who don’t drink, systolic blood pressure was 1.25 mm Hg higher in individuals who drank an average of 12 grams of alcohol daily, increasing 4.9 mm Hg in those who drank an average of 48 grams of alcohol per day. Twelve grams of alcohol equates to 12 ounces of regular beer, 5 ounces of wine. A one-and-a-half ounce of hard liquor contains roughly 14 grams of alcohol.

In adults that drank an average of 12 grams of alcohol per day, diastolic blood pressure was 1.14 mm Hg higher, increasing to 3.10 mm Hg in those that drank an average of 48 grams of alcohol daily.

A nearly linear association between baseline alcohol consumption and SBP changes in men and women and for DBP in men was observed. In women, an inverted U-shaped association was observed, meaning no safe level was noted.

Whelton notes that the WHO advises against any alcohol intake when it comes to blood pressure. His advice is, "If someone is already drinking alcohol and does not want to stop doing so, minimizing alcohol consumption is desirable; many guidelines recommend not starting to drink alcohol but in those already drinking alcohol, consumption of two or fewer standard drinks per day for men and one or less standard drinks of alcohol per day for women.”

Alberto Ascherio, MD, with Harvard T. H. Chan School of Public Health, Boston, said it's been known for more than 30 years that alcohol intake is associated with increased systolic and diastolic BP. The added value of this new study is a "refinement of the estimate of the dose-response."

Ascherio also commented that "moderate alcohol consumption is associated with a modest increase in risk of cancer, but, in spite of the adverse association with BP, with a potentially beneficial effect on cardiovascular disease." However, "the causality of the latter association has been questioned, but there is no consensus on this."

Timothy Brennan, MD, MPH, chief of clinical services for the Addiction Institute of Mount Sinai Health System in New York City, also chimed in and said this new study represents "yet another piece of evidence suggesting that there simply is no 'healthy' amount of alcohol use in humans.”

He notes, "Even small amounts of alcohol intake can have negative health effects, as demonstrated in this study. There is still a widely held belief among people that drinking in moderation is good for you. It is becoming more and more clear that this is simply not the case. As health authorities grapple with drinking 'recommendations,' additional datasets like these will be helpful."

While drinking socially is common in the US and many other countries, being “sober curious” or committing to dry January are a few ways to reduce alcohol intake. Below are some other ideas:

·        Don’t drink and drive. Remember that “buzzed driving” is drunk driving.

·        Be moderate when you drink. No more than two drinks per day for men and one per day for women.

·        Limit alcohol consumption to weekends only. Continue to be moderate.

·        Keep non-alcoholic drinks on hand to bring to parties. Flavored seltzer water, non-alcoholic beer, or club soda with lime are good substitutes.

·        Find a buddy that also wants to cut back on alcohol. Accountability may help reduce your intake.

·        Take up a fun sport in place of happy hour. Try pickleball in place of “getting pickled”.

·        Seek help if you or someone you love has a drinking problem. Have a problem with alcohol? There is a solution. | Alcoholics Anonymous (aa.org)

Lisa Andrews, MEd, RD, LD

References:

1.    Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies. Silvia Di Federico,Tommaso Filippini, Paul K. Whelton, Marta Cecchini, Inga Iamandii, Giuseppe Boriani and Marco Vinceti 31 Jul 2023 https://doi.org/10.1161/HYPERTENSIONAHA.123.21224Hypertension. 2023;0

2.    Have a problem with alcohol? There is a solution. | Alcoholics Anonymous (aa.org)