Is There a “Best” or “Worst” Alcohol To Drink if You Have High Blood Pressure?

It's true that alcohol, whether you have high blood pressure or not, will temporarily increase your blood pressure levels. And over time, if you drink more than one to two drinks per day, you increase your risk of hypertension that needs to be treated, according to the American Heart Association (AHA). Because high BP often doesn't have symptoms, you may not even realize the effect your drinking habits are having (unless you're getting regular checkups, that is).

But is there a drink that's the worst for people with high blood pressure? What about ones that are less bad?

Find out the link between high blood pressure and alcohol here, plus serving suggestions and how to lower BP levels to preserve your heart health (beyond saying "no" to that bar crawl).

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What's the worst alcohol for high blood pressure?

Unfortunately, the worst drinks for your blood pressure are, well, all of them. It's true, all types of alcohol can have a negative effect on your BP levels. If anything, it's more about how much you have, and how often you drink, that makes a difference.

"The effects of alcohol appear consistent across all types of alcohol, including wine, liquor, and beer," says Nihar Desai, MD, a cardiologist and associate professor at Yale School of Medicine in New Haven, Connecticut. "It's very important people understand that heavy alcohol use and binge drinking are associated with increases in blood pressure."

That's because alcohol (of any kind) constricts or tightens the muscles that surround your arteries. "When those muscles tighten, it leads to an increase in blood pressure," says Dr. Desai. Drinking regularly can also contribute to unhealthy weight gain, which can make your blood pressure go up, too, per the Mayo Clinic.

But what about red wine? It's long been touted as "good for heart health," but newer research suggests its benefits aren't as great as we thought. In fact, several studies have shown that drinking red wine regularly raises blood pressure, according to an April 2023 review in Nutrients¹.

"While red wine does have antioxidants like resveratrol which may help with heart health, it's still important to practice moderation," says Vandana Sheth, RDN, a registered dietitian nutritionist and diabetes specialist based in Los Angeles. "When consumed in excess, any type of alcohol, including red wine, is going to affect blood pressure," she adds.

"When consumed in excess, any type of alcohol, including red wine, is going to affect blood pressure." —Vandana Sheth, RDN, registered dietitian nutritionist

How much does alcohol raise your blood pressure?

In the moment, having one or two drinks may actually temporarily lower your blood pressure by a few points. This is because alcohol relaxes your blood vessels for about 12 hours after you drink, according to a July 2020 review in the Cochrane.

But after that short-term dip, alcohol can send your BP soaring, especially if you've had three or more drinks in one sitting, per the Mayo Clinic. You may even notice a high blood pressure reading the day after drinking, if you check your blood pressure at home. Exact BP points, however, all depend on the amount you drink.

For example, an October 2023 meta-analysis in Hypertension³, which included seven studies following more than 19,000 adults without high blood pressure, found that having an average of one drink per day raised systolic blood pressure (the top number) by around 1.25 points and diastolic blood pressure (the bottom number) by around one point over the course of five years.

Those numbers also rose the more people drank. According to the meta-analysis, people who had around 3.5 drinks per day saw their systolic blood pressure increase by nearly five points and their diastolic blood pressure increase by three points over five years.

How much alcohol can you drink per day?

Despite everything mentioned above, we know that moderation and balance is the key to most things in life. That's why if you choose to drink, experts say moderation is important. Most adults should stick with no more than one to two drinks per day, per the AHA.

This means paying attention to portion size is important, too, as a wine glass filled to the brim or an oversized margarita may actually count as two or three drinks, says Sheth.

A general rule of thumb? One drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor, per the AHA. And make sure you're drinking plenty of water between drinks and once you've finished drinking, to rehydrate your body.

How to lower your blood pressure levels

There's a lot you can do to bring down your BP if you're concerned about your numbers. If you drink, taking a look at your alcohol intake is a good place to start.

"Limiting or completely quitting drinking can lead to improvements in your blood pressure, especially if you're a regular or heavy drinker," says Sheth. This is when experimenting with different mocktail recipes, or choosing nonalcoholic drinks when you go out, can be fun and helpful.

Doing so can lead to fairly quick improvement. While there aren't many new studies on this topic, one hallmark 1999 study in Hypertension⁴ found that heavy drinkers who cut out alcohol altogether lowered their systolic blood pressure by seven points, and their diastolic blood pressure by six points in just one month. (Keep in mind, these numbers may vary greatly depending on the person.)

Other healthy habits you can implement to help lower your blood pressure include the following, per the Mayo Clinic:

• Eat a balanced diet: Adding more fruits, vegetables, whole grains, beans, and low-fat dairy products to your daily meals can slash BP by as much as 11 points. Lowering your sodium intake to 1,500 milligrams per day can also bring your BP down by five or six points.
• Exercise regularly: Regular physical activity (that is, getting exercise most days of the week) can bring down your BP by up to eight points. This can come in the form of aerobic activity like walking, biking, or swimming, and strengthening exercises like lifting weights or Pilates.
• Maintain a healthy weight for your body size: Having overweight can contribute to hypertension. For people with overweight, losing just five pounds can lead to a drop in blood pressure, according to the Mayo Clinic. (Not everyone with high blood pressure needs to lose weight, though, so check with a trusted doctor before making significant changes to your routine.)
• Get enough sleep: Getting seven to eight hours of quality sleep per night will help lower your blood pressure levels.
• Manage your stress levels: Stress is unavoidable in life, but reducing its effects whenever possible is important. This may mean incorporating relaxation techniques into your day, like gratitude journaling or yoga, or seeking therapy.
• Take blood pressure readings at home: If you've been diagnosed with hypertension, your doctor may ask that you check your levels at home with a portable monitor. Just be careful to avoid common mistakes when measuring blood pressure, like crossing your legs, holding your breath, or drinking caffeine right beforehand.

When to see your doctor about high blood pressure

Ultimately, the best and worst alcohol for high blood pressure doesn't really exist. All alcoholic drinks can have a negative effect on your blood pressure, especially if you drink in excess.

That said, if you have specific concerns about your blood pressure and heart health, or feel that your drinking habits have a negative effect on your health and well-being, it's always a good idea to let your doctor know.

If you're generally healthy and under 40 years old, you should have your blood pressure checked every two to five years. If you're 40 or older, get it checked annually, because the risk for high blood pressure increases with age, according to the Mayo Clinic. You may need more frequent checks if you have a chronic health condition like heart disease or diabetes.

FAQ

Does alcohol raise blood pressure the next day?

In short, yes. "It appears that heavy alcohol use can affect blood pressure for 12 to 24 hours; then persistent heavy alcohol use can also lead to sustained elevations in BP," says Dr. Desai. Within 13 hours of binge drinking, your systolic BP goes up by nearly four points and your diastolic BP goes up by 2.5 points, according to the Cochrane Database of Systemic Reviews.

Does quitting drinking lower blood pressure?

Yes, it does. "If you're a regular or heavy drinker, moderating your intake can be associated with many health benefits, including heart health benefits," like lower blood pressure, says Dr. Desai. You could drop your systolic BP by up to 5.5 points and your diastolic BP by up to four points, per the Mayo Clinic.

Does alcohol increase your heart rate?

Alcohol can temporarily increase your heart rate, and it doesn't take much for it to happen. Just one drink was found to raise a person's heart rate by an average of five beats per minute over a six-hour period, per the Cochrane review. Binge drinking, especially long term, can have a more significant effect. "There is an elevated risk not only of increased heart rate, but of an irregular heart rhythm, including conditions like atrial fibrillation," says Dr. Desai.

—reviewed by Jennifer Logan, MD, MPH