Yes, regular drinking raises blood pressure, with the top number about 1.3 points higher at one drink a day and about 5 points higher at four.
The two drinks I get asked about most are the glass of wine at night and the cup of coffee in the morning. Most people worry about the coffee. For blood pressure, the wine deserves more of the attention.
For years, headlines said a drink a day was good for your heart. The blood pressure studies point the other way. In long-term data, the rise started with the first daily drink and grew with each one after it.
The book's grade: HARMFUL (clear harm) for regular drinking, with heavy drinking doing the most harm. Cutting back if you drink more than 2 drinks a day is SUPPORTED (works), a Start here item. The grade is about drinking as a habit. A couple of beers once in a while won't do much, but a couple every night adds up.
What counts as one drink
In the US, one standard drink has about 14 grams of pure alcohol (NIAAA standard drink guide). That's:
- 12 ounces of regular beer
- 5 ounces of wine
- 1.5 ounces of spirits (one shot)
A big pour of wine or a strong craft beer can hold more than one standard drink.
How much does alcohol raise blood pressure?
Blood pressure is measured in millimeters of mercury (mmHg), which most people call points.
A review of 7 long-term studies followed 19,548 healthy adults. The top number (systolic) went up steadily as drinks went up, and the authors found no amount low enough to be free of this effect (review of alcohol and blood pressure):
- About 1 drink a day: top number about 1.3 points higher than in non-drinkers.
- About 4 drinks a day: about 5 points higher.
Can alcohol cause high blood pressure?
The chance of getting high blood pressure climbs the same way. In a review of more than 20 long-term studies, people who had about four drinks a day were about a third more likely to develop high blood pressure than people who had one. People who didn't drink at all had the lowest risk (review of alcohol and new high blood pressure).
Drinkers differ from non-drinkers in many ways, so researchers used a gene to test whether alcohol itself causes the rise. Many people of East Asian ancestry carry a variant that makes alcohol cause flushing and nausea, so they drink less. Men with the usual form of the gene had a top number about 7.4 points higher than men with two copies of the variant (gene study). Nobody chooses their genes, so habits and income are unlikely to explain that gap.
Does alcohol lower blood pressure?
For a few hours, yes. Then it can swing the other way.
A Cochrane review pooled 32 trials of a single dose of alcohol, mostly in healthy young men (Cochrane review):
- One to two drinks lowered the top number about 5.6 points for the next few hours.
- More than about two drinks lowered it for up to 12 hours. From about 13 hours on, it pushed the top number up about 3.7 points.
So a night of drinking can make your bedtime reading look good and your morning reading worse. Mark the nights you drank in your home log. And if you take blood pressure pills, stand up slowly after drinking, since the short-term drop adds to your medicine.
Is there a best or worst alcohol for high blood pressure?
The worst alcohol for your blood pressure is the one you drink most often and in the largest amounts. In a large Japanese study, beer, wine and spirits behaved alike (Japanese checkup study).
Red wine gets no exception either. In a trial of 24 healthy women, about one and a half to two glasses of red wine every evening for 4 weeks raised the 24-hour top number about 2 points compared with alcohol-free red wine. Under a glass a day made no clear difference (red wine trial).
Many people have heard that moderate drinking protects the heart. The 2025 American Heart Association and American College of Cardiology guideline says those studies were partly skewed by drinkers' other healthy habits and income, and that "aiming for abstinence appears to be optimal" (2025 AHA/ACC guideline). Nobody should start drinking because of a heart-health headline.
If you like the ritual of a glass with dinner, alcohol-free red wine may be worth trying. In a 4-week trial of 67 men at high heart risk, both numbers fell on it compared with regular red wine and gin, though the summary didn't give the size of the drop (alcohol-free wine trial). Grade: PLAUSIBLE (weak evidence).
How much does cutting back lower blood pressure?
It depends on how much you drink now. A review of 36 trials sorted people by their starting amount (review of cutting back):
- More than six drinks a day, cut by about half: the top number fell about 5.5 points and the bottom about 4.
- About three a day, cut to near zero: about 1 point on each number.
- Two a day or fewer: no clear change in the trials.
Each extra daily drink at the start added about 1 point to the drop. For a heavy drinker, that could mean going from 150/95 to about 145/91. That's about the same as cutting sodium by about 1,700 mg a day (review of salt reduction trials).
For lighter drinkers, the drop is smaller. In the large Japanese study, stopping one to two drinks a day went with about 1 point lower on the top number (Japanese checkup study). Grade for cutting back from 1 or 2 drinks a day: PLAUSIBLE (weak evidence). Priority: Add next.
The guideline's goal is not drinking at all, or no more than 1 drink a day for women and 2 for men. It also notes that no harms have been found from cutting back.
Try it yourself: two alcohol-free weeks
This is for people who have a drink or two most days. Heavy daily drinkers should read the safety section first.
- Take a week of morning readings the usual way while you drink as you normally do. My guide to taking your blood pressure at home covers the steps.
- Go two weeks without alcohol.
- Take morning readings again during the second alcohol-free week.
- Compare the two weekly averages, not single readings.
Readings drift on their own, so a change of less than about 5 points in your weekly average may be noise.
Safety: when to call your doctor
- If you drink heavily every day, don't stop all at once on your own. Alcohol withdrawal usually starts within 8 hours of the last drink and peaks at 24 to 72 hours. Its most severe form, delirium tremens, can cause sudden confusion, hallucinations and seizures, and it can be fatal (MedlinePlus on alcohol withdrawal). Talk to your doctor first so you can cut down safely.
- Already stopped and think you're in withdrawal? Contact your doctor right away or go to the emergency room. Call 911 for a seizure, fever, severe confusion, hallucinations or an irregular heartbeat.
- A reading over 180/120: wait at least a minute and check again. If it's still that high and you have chest pain, shortness of breath, weakness, a change in vision, a sudden severe headache or trouble speaking, call 911. With no symptoms, contact your doctor's office as soon as possible (the on-call line after hours). If you can't reach a person or get seen that day, go to urgent care.
- Never stop or change a blood pressure pill on your own. Keep taking your medicine as prescribed while you cut back. If your readings drop and you feel dizzy when you stand, call your doctor and let them adjust the dose.
Bottom line
Alcohol raises blood pressure a little with every daily drink, about 1.3 points at one a day and about 5 at four, and no amount was free of the effect. It lowers your pressure for a few hours, then can push it up the next morning. Heavy drinkers who cut back by about half lowered their top number about 5.5 points, which makes it one of the best changes on the list if it applies to you. If you drink heavily every day, cut back with your doctor's help, never all at once.
Questions people ask
Does alcohol lower blood pressure?
Only for a few hours. One to two drinks lowered the top number about 5.6 points for the next few hours. More than about two drinks pushed it up about 3.7 points from about 13 hours later, and regular drinking raises blood pressure over time.
How much does alcohol raise your blood pressure?
In long-term studies, about 1 drink a day went with a top number about 1.3 points higher than in non-drinkers, and about 4 drinks a day went with about 5 points higher. The effect grows with each daily drink.
Why is my blood pressure high the morning after drinking?
More than about two drinks lowered the top number for up to 12 hours, then pushed it up about 3.7 points from about 13 hours on.
What is the best alcohol for high blood pressure?
None. Beer, wine and spirits behaved alike in a large study, and red wine raised the 24-hour top number about 2 points in a 4-week trial. Alcohol-free red wine may be worth trying if you miss the ritual.
What the book ranks next to cutting back
Cutting back on heavy drinking sits in the Start here group of my upcoming book, Your Blood Pressure by the Numbers, next to the other big, proven changes. Two of its neighbors there are quitting smoking, SUPPORTED, which lowered the 24-hour top number about 3.5 points in a smoke-free week, and CPAP for sleep apnea, SUPPORTED with a small effect that shows most at night. It's coming soon.
For your morning cup, read does coffee raise blood pressure, or see the full ranked list of ways to lower blood pressure.