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This paper reviews research addressing the relationship be­tween alcohol usage and blood pressure levels. In non-alcoholic samples, the heaviest drinkers have the highest mean blood pressure when compared to moderate or light drinkers. These results appear to be stronger for systolic than for diastolic. Several studies show a less clear pattern, particularly when age is taken into account. At the low end of the drinking spectrum, the evidence is conflicting both between and within each sex: U-shaped, J- shaped, linear and threshold patterns have been reported. Studies which tested the relationship of alcohol to various physiologic correlates are re­viewed; a number of hypotheses are discussed (e.g., direct pressor effect, withdrawal effect), and several are raised for future research.Despite the lack of clear evidence for an independent relationship, the clinical, epidemiological, and experimental research strongly suggests that heavy consumers of alcohol are at risk for the development of high blood pressure. The findings have implications for physicians with respect to the non-pharmacological treatment of hypertension, as well as for public health policy relevant to prevention.