What is the role of alcohol in hypertension?
A morning blood pressure surge is a risk factor for cardiovascular mortality, and studies show that alcohol is a risk factor for stroke—primarily hemorrhagic stroke. A possible mechanism is related to alcohol’s circadian effect on blood pressure. Acutely, alcohol ingestion will lower blood pressure through vasodilation. However, hours later, blood pressure rises, possibly as a result of sympathetic activation. A recent Japanese trial demonstrated that ambulatory blood pressures surged in drinkers shortly after awakening.
The popular press has championed moderate alcohol intake as a treatment to reduce cardiovascular disease risk. Red wine, because of its antioxidant content, has been particularly noted. However, studies show that red wine’s purported benefits result from the different drinking and dietary habits of red wine drinkers, compared to those who drink primarily beer or spirits. Moderate alcohol intake (one to two drinks daily for men and one drink daily for women) may be beneficial by increasing high-density lipoprotein levels and lowering platelet aggregation. These benefits are seen mostly in older patients. The benefits disappear with higher amounts of alcohol intake or binge drinking. The World Health Organization estimates that worldwide alcohol consumption contributes 16% to the risk of becoming hypertensive.
Finally, while most studies do not find a direct correlation between alcohol consumption and kidney disease, some researchers note that drinking 30 g of alcohol daily (approximately three drinks) is associated with albuminuria.