Alcohol intolerance high blood pressure

Alcohol intolerance high blood pressure DEFAULT

Alcohol-induced hypertension: Mechanism and prevention

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If this happens to you when you drink, you need to stop immediately

People who turn red or suffer from facial blotches when drinking are likely to suffer from a serious disorder.

Research in South Korea has discovered that people who become flush in the face after consuming a few units of alcohol show they are at risk of alcohol related hypertension.

This is otherwise known as alcohol related-high blood pressure and can be a major cause of heart attacks, strokes and can put a major strain on blood vessels.

This is all due to something called acetaldehyde, a toxic produced by alcohol, which the liver breaks down.

However, those that have flush reactions to alcohol, means that their body is breaking down the compound much more slowly, causing it to stay in their system for longer and possibly causing greater harm.

Dr Jong Sung Kim of the Chungnam National University School of Medicine told the Daily Mail:

Facial flushing after drinking is always considered as a symptom of high alcohol sensitivity or even intolerance to alcohol, unless a patient is taking special medicine.

The facial flushing response to drinking usually occurs in a person who cannot genetically break down acetaldehyde.

To my knowledge, there has been no detailed research that has analysed the relationship between drinking and hypertension while considering individual responses to alcohol.

The team who conducted the study looked at the medical records of 1, Korean men with a variety of alcohol related history.

Of that number suffered from flushes, didn't suffer from flushes and were non-drinkers.

They found that flushers were more prone to the problem when they consumed more than four alcoholic drinks a week.

After adjusting for age, body mass index, exercise status, and smoking status, the risk of hypertension was significantly increased when flushers consumed more than four drinks per week. 

‘In contrast, in non-flushers, the risk increased with consuming more than eight drinks per week.’

Kyung Hwan Cho, President of the Korea Academy of Family Medicine added:

Facial flushing after alcohol drinking differs across gender, age, and ethnic groups.

In general, it is more common in women, the elderly, and East Asians versus Westerners.

Although there isn't a known reason why those who turn red have a greater risk of high blood pressure, the safest solution is to simply cut down on alcohol.

Dr Kim concluded.

Our research findings suggest that clinicians and researchers should, respectively, consider evaluating their patients' flushing response to alcohol as well as drinking amount in a daily routine care, and researching hazard by drinking.

HT Daily Mail, Lad Bible

More: The map of the world by alcohol consumption

Sours: https://www.indycom/news/drinking-alcohol-red-face-blotches-flushes-high-blood-pressure-hypertension-research-south-korea-acetaldehyde
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Alcohol sensitivity, alcohol use and hypertension in an older Chinese population: the Guangzhou Biobank Cohort Study


Although the J-shaped association between alcohol consumption and blood pressure (BP) is well known, the effect of alcohol sensitivity on this relationship is less clear. We studied the association of alcohol sensitivity and alcohol use with BP and hypertension. This cross-sectional analysis included 19  older participants from the Guangzhou Biobank Cohort Study recruited from to , using clinically measured BP and self-reported alcohol use and alcohol sensitivity. Alcohol use was rare in women, in whom light-to-moderate drinkers (< g ethanol per week) without alcohol sensitivity had lower systolic and diastolic BPs (mean difference (95% CI –) mm Hg and (–) mm Hg, respectively) and a reduced risk of hypertension ( (–)) relative to never drinkers. Similarly, excessive drinkers (⩾ g ethanol per week) without alcohol sensitivity had a significantly higher systolic and diastolic BP and risk of hypertension than did nondrinkers (mean difference (–) mm Hg, (–) mm Hg and 34% (8–66%), respectively, for men). These differences were even greater for men with alcohol sensitivity (mean differences (–) mm Hg, (–) mm Hg and 95% CI (46–%), respectively). Alcohol sensitivity and alcohol use were both associated with elevated BP and risk of hypertension in an older Chinese population. Alcohol sensitivity may aggravate the effect of drinking on BP. Limiting alcohol use to two drinks per day for men and one drink a day for women may be suitable for East Asians. Reduction of alcohol consumption should be an important public health target.


Alcohol has been reported to be a common and modifiable risk factor for hypertension,1 with a J-shaped relation. Light-to-moderate alcohol consumption may be beneficial for reducing the risk of hypertension, although residual confounding cannot be ruled out. In contrast, heavy drinking increases the risk of hypertension.2, 3, 4 The metabolism of alcohol involves the enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which break down ethanol into acetaldehyde and subsequently into acetic acid.5, 6 Sensitivity to alcohol is mainly because of functional differences in ALDH2 polymorphisms.6 Alcohol sensitivity is low in people with ALDH2*1/*l, intermediate in those with ALDH2*1/*2 and high in those with ALDH2*2/*2.7 Most of those who are sensitive to alcohol experience symptoms, such as facial flushing or palpitations, during alcohol consumption.8 Alcohol sensitivity is more common in East Asian than in Western populations.8, 9, 10 Alcohol sensitivity may modify the effect of alcohol on blood pressure (BP), possibly making alcohol less protective in East Asians, thus altering the appropriate definition of light-to-moderate drinking with corresponding public health implications. Earlier studies are few, small and inconsistent,11, 12, 13, 14, 15, 16 with no evidence from China or Chinese populations. Some studies showed that the effects of alcohol drinking on BP and incidence of hypertension were not different in individuals with high or low levels of ALDH2 activity.11, 12, 13, 14 However, two studies showed that there is a higher risk of hypertension associated with drinking large amounts of alcohol in those who are highly sensitive to alcohol.15, 16 In the Guangzhou Biobank Cohort Study (GBCS), data on drinking, alcohol sensitivity and BP have been collected in detail.17 We used baseline data from the GBCS to investigate the association between alcohol use, alcohol sensitivity and BP in an older Chinese population.


Sources of data

The GBCS is a collaborative project between the Guangzhou No. 12 Hospital, Guangzhou, China, the Universities of Hong Kong, Hong Kong, China and of Birmingham, UK, and has been described elsewhere in detail.17 Briefly, participants underwent a half-day session with a detailed medical interview, from which data on lifestyle habits (such as drinking, smoking and physical activity), socioeconomic position, symptoms after drinking alcohol, disease history and reproductive history were obtained. They also had a full physical examination, including BP assessment. This analysis is based on participants from phases 1 and 2 of the recruitment examined in – and –, respectively. The Guangzhou Medical Ethics Committee of the Chinese Medical Association approved the study and all participants gave their written, informed consent.

Of the 20  eligible participants, 19  (%), who had complete data on all items of interest, were included in the present cross-sectional analysis. The exclusion of (%) participants was largely because of missing physical activity data (n=, %), as the International Physical Activity Questionnaire18 was not introduced into the study until 1 month after the first phase of recruitment started.

Exposure assessment

The participants were asked about the usual (on a typical occasion or during a typical day) frequency (days per week) and amount (ml) of drinking alcoholic beverages, including beer, grape wine, rice wine and whisky. Mean weekly alcohol consumption (g ethanol per week) was then calculated and categorized into three groups: nondrinkers, light-to-moderate drinkers (LMDs) and excessive drinkers (EDs). Nondrinkers were defined as those who explicitly reported no drinking currently and previously, or drinking less than six times per year. LMDs were those who drank less than once per week (occasional drinking) or who, on an average, drank < g ethanol per week. EDs were weekly drinkers consuming, on an average,  g or more ethanol per week. The latter category could only be used for men as there were very few women who fulfilled the criteria. Self-reported alcohol intake has been found to be reliable and valid in populations.19

Alcohol sensitivity was assessed by asking ever drinkers ‘After drinking alcohol, do you usually experience facial flushing, palpitation and/or dizziness?’ An affirmative response is compatible with having alcohol sensitivity.15, 20

Outcome specification of hypertension

Seated BP was measured three times, 1 min apart, after a 3-minute rest, using the Omron CP (HEMCP-E) sphygmomanometer (Omron Matusaka Co. Ltd., Masusaka, Japan). The average of the last two readings was used. Pulse pressure was defined as the difference between systolic BP and diastolic BP. Mean artery BP was defined as diastolic BP plus one-third of pulse pressure. Hypertension was defined as systolic and/or diastolic BPs ⩾/90 mm Hg, or being on treatment with medication for hypertension.3

Statistical analysis

Means and 95% confidence intervals (95% CIs) are reported for BP. Number and percentage are reported for categorical variables. Analysis of covariance (ANCOVA) was used to calculate the age-adjusted means. Linear regression was used to assess the age-adjusted linear trend for alcohol sensitivity and amount of alcohol consumption. Logistic regression was used to estimate the risk of hypertension. The potential confounders considered were age, lifestyle habits (smoking and physical activity),18 socioeconomic position (education and personal annual income) and other vascular risk factors (family history of hypertension, body mass index, waist circumference, total cholesterol, triglyceride, HDL-cholesterol and glucose).

Models were built to investigate the possible confounding effects of each confounder in turn. We present three models: model 1 adjusted for age; model 2 additionally adjusted for lifestyle and socioeconomic position; and model 3 additionally adjusted for other vascular risk factors.

Ex-drinkers are more likely to have developed hypertension or to be receiving antihypertensive medication. Furthermore, reducing excessive alcohol intake can produce a reduction in BP.4, 21 Therefore, ex-drinkers were excluded for analyzing the association between alcohol use, alcohol sensitivity and BP to avoid possible bias.


There were more women (13 ) than men (), and the women were generally younger (mean age years (s.d.±)) than the men (mean age years (s.d.±)). Male and female drinkers with alcohol sensitivity were slightly younger than drinkers without sensitivity and nondrinkers (Table 1).

Full size table

Ex-drinkers and current drinkers accounted for % ( of 13 ) and % ( of 13 ) in women and % ( of ) and % ( of ) in men, respectively. Among ever drinkers, the prevalence of alcohol sensitivity was % ( of ) in men, which was similar to that in women (% ( of ), P=). However, the amount of alcohol consumed was greater in men than in women. Among ever drinkers, the proportion of ED in men (%, of ) was much higher than that among women (%, 55 of ), P< The proportion of ED in those with alcohol sensitivity was lower than that among those without alcohol sensitivity ( vs. % in men and vs. % in women, respectively, Table 1).

In addition, the prevalence of smoking was higher in drinkers, with over 80% of male ever-drinkers being ever smokers. The prevalence of ever smoking was significantly higher among men than among women. Most of the participants had had primary to secondary education, with an annual personal income of 10 –15  Yuan (8 Yuan=1 USD), and were physically active. Nondrinkers tended to more likely report a family history of hypertension. Women were more likely than men to have a large waist circumference and elevated total and low-density lipoprotein-cholesterol levels. There were also some minor differences in lipid profile among nondrinkers and ever drinkers, with and without alcohol sensitivity, but no difference in blood glucose levels.

Alcohol consumption, alcohol sensitivity and BP

Table 2 shows that in men, EDs had higher mean systolic, diastolic, pulse and arterial BPs than did nondrinkers, regardless of alcohol sensitivity, adjusted for age. EDs with alcohol sensitivity had the highest systolic, diastolic, pulse and mean arterial BP. Furthermore, all these BP measures were significantly higher in EDs with alcohol sensitivity than in those without alcohol sensitivity. We additionally stratified EDs into two groups (– and ⩾ g ethanol per week), and the observations were consistent in each group (Appendix 1). However, BP was almost the same in nondrinkers and in LMDs regardless of alcohol sensitivity. Light-to-moderate drinking was not associated with an elevated BP in men. A stratified analysis by medication for hypertension, the association between alcohol use, alcohol sensitivity and BP remained unchanged (data not shown).

Full size table

Table 3 shows that, in women, LMDs with or without alcohol sensitivity had significantly lower adjusted mean systolic, diastolic, pulse and arterial BPs than did nondrinkers (P-values from to <). The interquartile (P25, P50, P75) levels of alcohol intake (g ethanol per week) in the LMDs who drank once per week or more were 11, 27 and 54, respectively, in women, and 28, 54 and 84, respectively, in men. In stratified analysis by medication for hypertension, the results were similar (data not shown).

Full size table

Table 4 shows that the results were similar when the prevalence and adjusted odds ratios (ORs) of hypertension were examined. The prevalence of hypertension was % ( of ) in men and % ( of 13 ) in women. Compared with nondrinkers, the prevalence of hypertension was lower in LMDs, both in men and women, and higher in male EDs. Male EDs, especially those with alcohol sensitivity, had a higher risk of hypertension, whereas female LMDs had a lower risk of hypertension, especially those without alcohol sensitivity. The association between alcohol use, alcohol sensitivity and hypertension remained consistent when the data were stratified by dividing EDs into two groups (– and ⩾ g ethanol per week) (Appendix 2).

Full size table


In a large sample from an understudied Chinese population, with adjustment for many confounders, including lifestyle habits, socioeconomic status and other vascular risk factors, we found that alcohol sensitivity was associated with higher BP in light-to-medium drinkers compared with that in similar drinkers without alcohol sensitivity, in both men and women. Excessive drinking men with alcohol sensitivity also had higher BP and risk of hypertension than did equivalent EDs without alcohol sensitivity.

Although alcohol-induced flushing is thought to be a deterrent factor to heavy consumption of alcohol,20, 22, 23 the frequency of drinking of alcoholic beverages does not always differ between flushers and nonflushers.24 Social, psychological and cultural influences may be a better explanation for alcohol use among East Asians than alcohol sensitivity.25 There is a lack of data describing the association between alcohol sensitivity and hypertension for Chinese or other East Asians, except the Japanese. Studies from Japan have had inconsistent results.11, 12, 13, 14, 15, 16 For example, a study including people from the general population showed that the ALDH2 genotype does not affect sensitivity to the pressor effects of alcohol in either men or women.13 However, studies on male workers showed that heavy drinkers with sensitivity to alcohol (slight and visible face and/or skin flushing after drinking) had a higher risk of hypertension.15, 16 Our study also suggests that sensitivity to alcohol may aggravate the effect of excessive alcohol drinking on hypertension. Chronic alcohol intake by alcohol flushers increases blood acetaldehyde levels and thereby raises BP.15 In women with hypertension, LMDs with alcohol sensitivity had a significantly higher BP (compared with LMDs without alcohol sensitivity) than did women without hypertension. In both men and women, the study showed that light-to-moderate drinking may not reduce BP in those who are sensitive to alcohol.

We found that in men, regular excessive drinking was associated with elevated BP and risk of hypertension, which is consistent with earlier reports.26, 27, 28, 29 However, we could not find a beneficial effect from light-to-moderate drinking. We used the same drinking definitions in women as in an earlier study,30 but which are slightly higher than the recommendation of limit to one drink (∼ g ethanol) per day proposed by the US Department of Health and Human Services and of Agriculture.31 We found that light-to-moderate drinking was associated with lower BP and risk of hypertension in women, especially in those without alcohol sensitivity. However, most of the woman alcohol users would have been occasional users, hence it is difficult to ascertain whether this was a real effect of occasional alcohol use or was because of residual confounding from other characteristics of the fairly uncommon woman drinkers (such as more health consciousness or self-restraint). Certainly, levels of alcohol intake in the light-to-moderate female drinkers who drank once per week or more were approximately half of those observed in the men, which may contribute to the observed differences. A prospective cohort study showed a strong positive association between higher alcohol consumption and an increased risk of developing hypertension in men, with no evidence of benefit in light-to-moderate drinking.3 The risk of hypertension was much higher in men when total alcohol consumption exceeded five drinks per week. However, in women, light-to-moderate alcohol consumption contributed to a modestly lower hypertension risk.3 In another prospective study, alcohol intake of up to 20 g alcohol per day was not associated with an increased risk of hypertension in women.32 A population-based study including US adults showed that alcohol intake of up to two drinks per day had no effect on BP. There was a sex-specific effect of alcohol intake in excess of two drinks per day on BP, with increased BP in men but not in women.33 Excessive alcohol intake has been shown to be associated with increased arterial stiffness in men.34 In contrast, higher alcohol use was inversely related to arterial stiffness in women.35

A chronic low ethanol intake for LMDs may confer benefits mainly through higher antioxidant capacity and lower advanced glycation end products.36 There was no beneficial effect of light-to-moderate drinking on BP in men in our study. This could be because most of the male drinkers also smoked, whereas female drinkers did not. In our study, we found that the prevalence of ever smoking in current drinkers was % in men and % in women. There is some evidence that the association between alcohol drinking and higher BP is stronger in smokers than in nonsmokers. A Japanese study found that BP was significantly higher in heavy drinkers than in nondrinkers, and these differences tended to be greater in light and heavy smokers than in nonsmokers.37 Furthermore, the relatively greater prevalence of drinking and the larger amount of alcohol consumption in men (vs. women) in China may also, in part, explain the discrepancy in the effect of alcohol intake on BP in men and women.

Alcohol consumption is an established cause of cancer of the mouth, pharynx, larynx, esophagus, liver, colon, rectum and breast.38 For each of these cancers, risk increases substantially with an intake of more than 50 g of alcohol per day.38 A regular consumption of one or more drinks per day has been associated with an increased risk of breast cancer in women.39 Given the evidence from this study and others, it is suggested that people should not drink, but for those who do, alcohol intake should be limited to no more than two drinks per day (∼20–25 g ethanol per day) for men and one drink a day (∼10–15 g ethanol per day) for women.31 This may be suitable for Chinese adults and other Asians, in whom alcohol sensitivity is common. For the prevention of cancer and many other alcohol-related health problems, ceasing or reducing alcohol consumption should be an urgent public health target.

This is a large study in older Chinese including data on alcohol sensitivity, alcohol consumption, BP and medication for hypertension. The use of a standardized, detailed questionnaire and the measurement of fasting biochemical vascular risk factors enabled the adjustment of many potential confounders. These have allowed us to examine the independent association of alcohol sensitivity and alcohol consumption with BP and hypertension. To the best of our knowledge, this is the first large study on alcohol sensitivity, alcohol use and BP in a Chinese population, which may give evidence for alcohol control, especially for the many developing populations during a period of transition with massive promotion and a consequent rapid increase in alcohol consumption. Despite the strengths, there are some limitations. First, our findings would be biased if people with specific patterns of alcohol use and hypertension risk were systematically excluded, most likely heavy drinkers. However, heavy drinking is rare among Chinese. Second, our study is based on data from older people for whom the social and cultural setting means heavy alcohol use is uncommon, and thus precluded a full exploration of the effects of very high alcohol use, particularly in women. Third, our study from a setting in which rice wine and beer are the main alcoholic beverages means we cannot examine whether grape wine specifically is protective against hypertension; however, this does not detract from the relevance to China and other Asian populations. Fourth, we did not adjust for potential confounding by diet, especially by dietary sodium, which is an independent factor on BP. However, Cantonese are not heavy salt users, so confounding by dietary sodium is likely to be minimal. Moderate alcohol use can be associated with a healthier diet;40 however, that pattern may be culturally specific. We cannot rule out the possibility that Chinese moderate alcohol users have a particularly unhealthy diet, which may mask a protective effect of moderate alcohol use on BP. Finally, this is a cross-sectional study, with all the inherent limitations, including the inability to determine causality.

In conclusion, excessive drinking with alcohol sensitivity may aggravate the detrimental effects of excessive drinking on BP and hypertension. Light-to-moderate drinking may be associated with reduced BP and risk of hypertension only in women, especially in women who are not sensitive to alcohol. Limiting alcohol consumption for those who drink to two drinks per day for men and one drink a day for women may also be appropriate for East Asians in whom alcohol sensitivity is common. Ceasing or reducing alcohol consumption should be an important public health target.


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Download references


The Guangzhou Cohort Study investigators include the following: Guangzhou No. 12 Hospital: WS Zhang, XQ Lao, M Cao, T Zhu, B Liu, CQ Jiang (Co-PI); The University of Hong Kong: CM Schooling, SM McGhee, RF Fielding, GM Leung, TH Lam (Co-PI); The University of Birmingham: P Adab, GN Thomas, P Yin, KB Lam, KK Cheng (Co-PI). We also thank Prof Sir R Peto and Dr ZM Chen of the Clinical Trial Service Unit, The University of Oxford for their support. This study was funded by The University of Hong Kong Foundation for Development and Research, and the University of Hong Kong University Research Committee Strategic Research Theme Public Health, Hong Kong; Guangzhou Public Health Bureau, Guangzhou Science and Technology Bureau, and Guangzhou No. 12 Hospital, Guangzhou, China; and the University of Birmingham, UK.

Author information


  1. Guangzhou Number 12 Hospital, Guangzhou, Guangdong, China

    Wei Sen Zhang, Chao Qiang Jiang & Bin Liu

  2. Unit of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK

    Kar Keung Cheng, Peymane Adab, G Neil Thomas & Kin-Bong Hubert Lam

  3. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

    C Mary Schooling & Tai Hing Lam

Corresponding author

Correspondence to Kar Keung Cheng.


Appendix 1

Table A1

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Appendix 2

Table A2

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Zhang, W., Jiang, C., Cheng, K. et al. Alcohol sensitivity, alcohol use and hypertension in an older Chinese population: the Guangzhou Biobank Cohort Study. Hypertens Res32, – ().

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Ask Dr. Rowena - High Blood Pressure \u0026 Alcohol

Alcohol and blood pressure

One in three adults in the UK has high blood pressure1, also known as ‘hypertension’. Alcohol can play a role in high blood pressure but you can keep your risk low by following the government’s guidelines.

What is high blood pressure?

When your heart beats, it pumps blood round your body to give the body the energy and oxygen it needs. Pressure is needed to make the blood circulate. The pressure pushes against the walls of your arteries (blood vessels) and your blood pressure is a measure of the strength of this pushing, combined with the resistance from the artery walls.

A normal heart pumps blood around the body easily, at a low pressure. High blood pressure means that your heart must pump harder and the arteries have to carry blood that’s flowing under greater pressure.

This puts a strain on your arteries and your heart, which in turn increases your risk of a heart attack, a stroke or of suffering from kidney disease2

What are the symptoms of high blood pressure

You can't usually feel or notice high blood pressure.

The British Heart Foundation estimate that around seven million people with high blood pressure are undiagnosed3.

This is because high blood pressure very rarely causes any obvious symptoms.

What causes high blood pressure?

There isn’t always a clear explanation as to why someone’s blood pressure is high. However, there are several factors that can play a part in increasing the risks of developing hypertension:

  • Regularly drinking alcohol beyond the low-risk guidelines
  • Not doing enough exercise
  • Being overweight
  • A family history of high blood pressure
  • Consuming too much salt

Tips to cut down your drinking

How to tell if you have high blood pressure

Due to the lack of noticeable symptoms, hypertension is a silent health condition. The only way of knowing if there’s a problem is to have your blood pressure measured. You can have this done at your GP surgery, some local pharmacies, or you can buy a blood pressure monitor from the chemist.  

A blood pressure reading consists of two numbers or levels, the systolic pressure and the diastolic pressure: unless your doctor tells you otherwise, your blood pressure should be below /90mmHg5.

Effects of high blood pressure

High blood pressure is a major cause of stroke and heart attack.

You can reduce your risk of having a stroke or heart attack by lowering your blood pressure.


A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off.  

Uncontrolled high blood pressure puts a strain on blood vessels all over the body, including vital arteries in the brain. This strain can cause vessels to weaken or become clogged up, which in turn can lead to blockage of the blood vessels taking blood to the brain or bleeding into the brain.

Either way it can result in a stroke.

Strokes are a medical emergency and urgent treatment is essential because the sooner a person receives treatment for a stroke, the less damage is likely to happen. You can recognise a stroke using the FAST test:

  • FACIAL weakness: Can the person smile? Has their mouth or eye drooped?
  • ARM weakness: Can the person raise both arms?
  • SPEECH problems: Can the person speak clearly and understand what you say?
  • TIME to call

If a person fails any one of these tests, phone immediately and ask for an ambulance.

Heart attack

A heart attack is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle

If you have high blood pressure, you’re also more at risk of having a heart attack or developing heart disease in the future. Because of the increased strain on your heart and blood vessels, untreated high blood pressure can cause angina (chest pain and breathlessness caused when the blood supply to the muscles of the heart is restricted) and may eventually lead to a heart attack.

The symptoms of a heart attack vary from one person to another. You may feel tightness or pain in your chest. This may spread to your arms, neck, jaw, back or stomach. For some people, the pain or tightness is severe, while others can feel nothing more than a mild discomfort. As well as having chest pain or discomfort you can feel light-headed or dizzy and short of breath. You may also feel nauseous or vomit.

The sooner you get emergency treatment, the greater your chances of survival and the more of your heart muscle can be saved.

Phone for an ambulance immediately if you suspect you, or someone else, is having a heart attack.

Other effects of high blood pressure are kidney damage and damage to the retina (the light-sensitive lining at the back of the eye which allows you to see4.

Are you drinking too much?

How to reduce high blood pressure

You can lower your blood pressure by making changes to your lifestyle:

  • Cut down on alcohol. Alcohol can have a serious long-term effect on blood pressure and research has shown that heavy drinking can lead to increased risk of hypertension for both men and women6
  • Healthy diet and exercise help to lower blood pressure 
  • Keep caffeine to a minimum: it can temporarily raise your heart rate and your blood pressure. If you regularly have more than four cups a day, it’s a good idea to start cutting down.

Can stress and bad temper cause high blood pressure?

Stress raises your heart rate, and therefore your blood pressure, in the short term. But it’s not been proven that stress alone has a long-lasting effect on your blood pressure.

However, the things people tend to do to combat stress, such as eating junk food and drinking to excess, can cause long-term blood pressure problems. If you experience stress, try alternative ways of coping with it, such as exercise or talking to a friend about what’s worrying you. 

Drinking alcohol is not an effective way to alleviate mental health difficulties. 

How to stop drinking completely

Staying in control of your drinking

The UK Chief Medical Officers' (CMO) low risk drinking guidelines advise that people should not regularly drink more than more than 14 units a week to keep health risks from alcohol low. If you do choose to drink, it is best to spread your drinks evenly throughout the week.

A healthy meal before you start drinking, and low-fat, low-salt snacks between drinks can help to slow down the absorption of alcohol. They’ll help keep your blood pressure down too.

If you want to cut down, a great way is to have several drink-free days a week. Test out having a break for yourself and see what positive results you notice.

Further information

Your GP can help you figure out if you should make any changes in your drinking, and offer help and advice along the way.

Blood Pressure Association offer a range of information to help you take control of, or prevent, high blood pressure  Information line: 

British Heart Foundation for help, facts and lifestyle advice. Heart Helpline:

The Stroke Association: for information or advice about stroke. Stroke Helpline:  

Was this information helpful?


Tips to change your relationship with alcohol


Blood alcohol pressure high intolerance

High blood pressure due to alcohol. A rapidly reversible effect

The hypothesis that the action of alcohol on blood pressure is rapidly reversible and that its effect is therefore mainly due to very recent alcohol consumption was examined in this study. Five hundred and seventy-seven subjects were screened in an occupational survey. Alcohol consumption, documented with a 1-week retrospective diary was divided into two categories: "recent" and "previous" intake. Recent intake was defined as the amount consumed on days 1, 2, and 3 immediately preceding blood pressure measurement. Previous intake was defined as the amount consumed on days 4, 5, and 6 preceding blood pressure measurement. High recent alcohol intake significantly raised systolic and diastolic blood pressure in both men and women. Previous alcohol intake, however, did not appear to influence blood pressure. We conclude that the effect of alcohol on blood pressure appears to be predominantly due to alcohol consumed in the few days immediately preceding blood pressure measurement, with alcohol consumption before those few days exerting little effect on blood pressure.

Blood Pressure Affected by Alcohol


The findings contrast with some previous studies that have associated moderate drinking with a lower risk of some forms of heart disease. Most previous studies, however, have not assessed high blood pressure among moderate drinkers. Since hypertension is a leading risk factor for heart attack and stroke, the new study calls into question the notion that moderate alcohol consumption benefits heart health.

"I think this will be a turning point for clinical practice, as well as for future research, education and public health policy regarding alcohol consumption," said Amer Aladin, MD, a cardiology fellow at Wake Forest Baptist Health and the study's lead author. "It's the first study showing that both heavy and moderate alcohol consumption can increase hypertension."

Alcohol's impact on blood pressure could stem from a variety of factors, according to researchers. Because alcohol increases appetite and is, itself, very energy-dense, drinking often leads to greater caloric intake overall. Alcohol's activities in the brain and liver could also contribute to spikes in blood pressure.

Data for the research came from the National Health and Nutrition Examination Study (NHANES), a large, decades-long study led by the Centers for Disease Control and Prevention. Specifically, the researchers analyzed data from 17, U.S. adults who enrolled in the NHANES study between and , the NHANES phase with data that is considered most complete and representative of the U.S. population.

Participants reported their drinking behavior on several questionnaires administered by mail and in person. Their blood pressure was recorded by trained personnel during visits in participants' homes and at a mobile examination center.

The researchers split participants into three groups: those who never drank alcohol, those who had seven to 13 drinks per week (moderate drinkers) and those who had 14 or more drinks per week (heavy drinkers). They assessed hypertension according to the ACC/AHA high blood pressure guideline, which defined Stage 1 hypertension as having systolic blood pressure between or diastolic pressure between , and Stage 2 hypertension as having systolic pressure above or diastolic pressure above

Compared with those who never drank, moderate drinkers were 53 percent more likely to have stage 1 hypertension and twice as likely to have stage 2 hypertension. The pattern among heavy drinkers was even more pronounced; relative to those who never drank, heavy drinkers were 69 percent more likely to have stage 1 hypertension and times as likely to have stage 2 hypertension. Overall, the average blood pressure was about /67 mm Hg among never-drinkers, /79 mm Hg among moderate drinkers and /82 mm Hg among heavy drinkers.

In their analysis, researchers adjusted for age, sex, race, income and cardiovascular risk to separate the effects from alcohol consumption from other factors with known links to hypertension.

Aladin said the study's large sample size likely helps explain why the findings appear to contrast with previous studies in this area. Studies involving fewer participants or only one medical center would not have the same statistical power as one using a large, national data set such as NHANES.

"This study is not only large but diverse in terms of race and gender," Aladin said. "The results are very informative for future research and practice. If you are drinking a moderate or large amount of alcohol, ask your provider to check your blood pressure at each visit and help you cut down your drinking and eventually quit."

Researchers didn't find any significant difference in blood pressure and alcohol intake by gender or ethnic/racial background. They plan to further analyze the data for insights on how demographic factors might influence the relationship between alcohol consumption and high blood pressure.

Aladin will present the study, "Alcohol Consumption and Risk of Hypertension," on Sunday, March

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Facial flushing is a sign of &#;alcohol intolerance&#;

“Flushing red after drinking is bad sign for boozers,” Metro reports.

A Korean study suggests that people who do flush after drinking could be more vulnerable to the harmful effects of alcohol on blood pressure.

The study compared the risk of high blood pressure in men who flush after consuming alcohol, compared with “non-flushers”.

It found that when “flushers” have more than four drinks a week their risk of high blood pressure was increased to a potentially hazardous level. While in non-flushers the risk only increased when they had more than eight drinks weekly.

Researchers speculate that “flushers” may have a faulty version of a gene ALDH2, which, when working, breaks down a substance in alcohol called acetaldehyde. And it could be excess amounts of acetaldehyde that is causing both facial flushing and high blood pressure.

However, a causal relationship between the two remains unproven.

It would also be dangerous to conclude that, if you are not a flusher, you can happily booze with impunity. Excess alcohol consumption, whether or not it turns the face red, can increase the risk of liver disease, many types of cancer and mental health problems. Read more about the dangers of drinking too much alcohol.

Where did the story come from?

The study was carried out by researchers from Chungnam National University and University of Ulsan, both in South Korea. There is no information about external funding.

The study was published in the peer-reviewed medical journal, Alcoholism: Clinical and Experimental Research.

It was covered fairly, if uncritically, in the Mail Online, who pointed out that no direct link between flushing and high blood pressure has been established.

Metro’s coverage was not so good. It reported that a “stingy” five drinks a week is enough to do damage for “scarlet-cheeked tipplers”, but did not point out that in the study a “drink” was defined as 14g of alcohol according to US guidelines. (In the UK a unit equals 8g of alcohol).

What kind of research was this?

This was a cross-sectional study that looked at the role of facial flushing after drinking, in the relationship between alcohol consumption and high blood pressure.

Cross-sectional studies look at all data at the same time, so cannot be used to see if one thing follows another, but they are useful for showing up patterns or links in the data.

The researchers point out that excessive drinking is a known risk factor for high blood pressure and that facial flushing is a well-known symptom of alcohol intolerance.

It indicates a gene mutation with the ALDH2 gene that makes it hard for the body to break down acetaldehyde, the compound produced when alcohol is metabolised by the liver.

They also point out that the prevalence of alcohol-related facial flushing differs across ethnic groups, and is more commonly found in Asians, including Koreans. They suggest that acetaldehyde, which causes facial flushing, may also be one of the causes of alcohol-related high blood pressure.

What did the research involve?

The participants in this cross-sectional study consisted of 1, healthy adult men who received comprehensive medical health check-ups between June and December They were categorised as:

  • non-drinkers ()
  • those who drank and experienced facial flushing with alcohol consumption ()
  • those who drank and did not experience the flushing response ()

Men who had taken any medication except anti-blood pressure drugs were not eligible.

Data on all the participants was collected from their medical records. This included information on blood pressure, drugs to control blood pressure, age, body mass index (BMI), waist circumference, smoking, exercise, drinking status and flushing response related to drinking.

The researchers defined 14g of alcohol as a standard drink, according to US guidelines. The men’s weekly drinking was calculated based on drinking frequency per week and drinks per drinking day. Drinkers were divided into categories:

  • four drinks or less
  • more than four and up to eight drinks
  • above eight drinks per week

They say these drinking categories are relatively easy to use in Korean medical interviewing because one bottle of soju contains four standard drinks. Soju, hugely popular in Korea, is a vodka-type drink traditionally distilled from rice.

A simple questionnaire was used to assess the facial flushing response. People were asked if they experienced flushing in the face immediately after drinking a glass of beer, with responses categorised as always, sometimes, or never. All three categories of flushing (current always, former always, and sometimes) were classified as flushing.

They analysed their results using standard statistical methods. They adjusted their results for age, body mass index, exercise status and smoking status.

What were the basic results?

Researchers found that % of the men had facial flushing reaction to alcohol (a higher percentage than that found in Westerners). When compared to a reference group of non-drinkers:

  • In flushers, the risk of high blood pressure was significantly increased when they consumed more than four drinks per week and up to eight drinks (odds ratio (OR) , 95% confidence interval (CI) to ) and above eight drinks (OR , 95% CI to ).
  • In non-flushers, the risk of high blood pressure was increased with alcohol consumption of more than eight drinks per week (OR , 95% CI to ).
  • The risk of flushers having high blood pressure was greater in the flushing groups compared with the non-flushers. For those consuming more than four and up to eight drinks (OR , 95% CI to ), and above eight drinks (OR , 95% CI to ).

Other comparisons made, including those for people drinking less than four drinks a day, were not statistically significant.

How did the researchers interpret the results?

The researchers say their findings suggest that high blood pressure associated with alcohol consumption has a “lower threshold value” and higher risk in flushers than in non-flushers. 

Koreans and other Asian groups, who have higher rates of flushing after alcohol, may therefore be at increased risk of high blood pressure. The researchers also point out that overall, the drinking amount that increased the risk of high blood pressure was lower than in Western studies, because of ethnic differences in body type and weight.

Doctors, they argue, should consider evaluating their patients’ ethnic group and flushing response as well as drinking amount, when assessing health.


There are several limitations to this cross-sectional study:

  • This type of study cannot tell us if facial flushing is related to a higher risk for high blood pressure, a health problem that is associated with many factors. 
  • It relied on men self-reporting both drinking habits and whether or not they flushed afterwards.
  • The subjects were all Korean adult males, so the conclusions may not apply to other groups.

That said, the study may be useful in pointing up differences in the risks of alcohol consumption for Koreans and other Asian groups and points the way to further study of the mechanisms for any increased risk.

However, it would be dangerous to conclude from this study that “non-flushers” can drink with impunity. Excess alcohol consumption, whether or not it turns the face red, is associated with many risks to health, of which high blood pressure is just one.

While the association between flushing and a dangerous spike in blood pressure levels is inconclusive, if you do find yourself flushing after a few beers, it could be that you are intolerant to alcohol – in addition to the normal toxic effects.

Excess levels of acetaldehyde could have other dangerous effects aside from blood pressure levels.

NT Contributor


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