Alcohol and hypertension: new insights from population studies

The link between alcohol and blood pressure is now well established. Certain subsets, such as older persons, whites and perhaps men may be at increased susceptibility to an alcohol pressor effect, although considerable interindividual variation in the pressor response probably exists. A threshold may exist at around two drinks per day, but several studies report either different thresholds or more linear relationships. The evidence to date suggests that ethanol, rather than some other constituent of alcoholic beverages or an associated behavior, raises blood pressure. The data available to date are perhaps most compatible with a withdrawal hypothesis, but a straightforward pressor effect cannot be excluded at this time. Whatever the mechanism, the pressor effect appears to be fully reversible. Finally, the available evidence suggests that alcohol induced hypertension will indeed lead to the usual hypertensive sequelae.