High Blood Pressure And Alcohol Use


Various groups of blood pressure medications are used for the management of hypertension, many of them should not be taken with alcohol. Alcohol-containing medications and alcoholic beverages may enhance the effect of blood pressure medications and cause unwanted side effects.

Alcohol and diuretics

Patients taking the FDA-approved diuretics – Hydrochlorothiazide or Furosemide after the alcohol use, may experience orthostatic hypotension (sudden drop in blood pressure when standing up).

The danger of the interaction of these blood pressure medications and alcohol is that because of orthostatic hypotension, heart rate increases, cerebral blood circulation is disturbed, as well as the risk of falls and fractures increases.

If potent diuretics are used to treat hypertension, abstain from alcohol use. It should be noted that in the USA, Hydrochlorothiazide is used only in the combination with other antihypertensive medications.

Combined blood pressure medications containing diuretic agent – Hydrochlorothiazide are sold at the U.S. pharmacies under the trade names: Amturnide, Tekturna HCT, Tribenzor, Exforge HCT, Lotensin HCT, Ziac, Atacand HCT, Vaseretic, Teveten HCT. The most popular proprietary name of Furosemide diuretic is Lasix.

Alcohol and ACE inhibitors

Blood pressure medications included in the group of ACE inhibitors do not interact with alcohol. However, alcohol may enhance side effects of ACE inhibitors, especially immediately after the beginning of antihypertensive therapy.

In the first days of using ACE inhibitors, dizziness and faints may occur. After alcohol use, the risk of these side effects increases.

Alcohol is not contraindicated in people taking ACE inhibitors. However, before consuming alcohol before or after using such blood pressure medications, make sure that ACE inhibitors do not cause severe adverse reactions.

It should be noted that ACE inhibitors are often prescribed in conjunction with diuretics that should not be used with alcohol. Thus, if diuretics and ACE inhibitors were prescribed as a combined antihypertensive therapy, refrain from alcoholic beverages (including low-alcohol).

At the US pharmacies, you can find many ACE inhibitors used to reduce blood pressure, including Benazepril (Lotensin) tablets and Captopril (Capoten) tablets.

Alcohol and Beta blockers

Just as ACE inhibitors, Beta-blockers do not interact with alcohol. However, after the use of Beta-blockers and alcohol, severe side effects may occur.

After using alcohol together with blood pressure medications from Beta-blockers group, the heart rate slows down, as well as dizziness, nausea, appetite loss, and digestive disorder may occur.

When using small doses of Beta-blockers and a small amount of alcohol, side effects occur rarely. However, if diuretics are used to reduce blood pressure besides Beta-blockers, abstain from alcohol during the whole course of combined antihypertensive therapy.

Beta-blockers are available at the U.S. pharmacies under various trade names. For example, Nadolol tablets are more known under original name Corgard, but Atenolol tablets are available under the brand Tenormin.

Alcohol and Alpha-blockers

When Alpha-blockers are used as hypertension monotherapy, the consumption of moderate amount of alcohol is allowed with caution. When using alcohol before, during or after using blood pressure medications from Alpha-blockers group, dizziness and drowsiness may occur. Because of these side effects, the likelihood of accidental falls and injuries increases.

Particular caution should observe those, who after using blood pressure medications and alcohol, was physically active, stand for long periods of time, as well as those whose body was exposed to high temperatures. In these cases, the risk of dizziness, fainting, falls and injuries significantly increases.

Some of the most effective Alpha-blockers are Doxazosin and Prazosin. Doxazosin blood pressure medication is well known under the brand Cardura, Prazosin is sold under the brand name Minipress.

Alcohol and calcium channel blockers (CCB)

Blood pressure medications from CCB group interact with alcohol in different ways. For instance, the maximum doses of Amlodipine CCB do not increase the concentration of alcohol in the blood, but Verapamil CCB may increase the concentration of alcohol in the blood and thereby enhance its effect.

The use of alcohol and antihypertensive medications from CCB group is not contraindicated. However, those who regularly take blood pressure medications and periodically consume alcohol beverages should remember that alcohol affects hemodynamics and can reduce the effectiveness of antihypertensive therapy.

For several decades, Verapamil blood pressure medication is sold in the USA under the trade name Calan, but Amlodipine – under the trade name Norvasc. At the international pharmaceutical market, cheap antihypertensive medications – Verapamil and Amlodipine can also be sold under other trade names, including nonproprietary names Amlodipine Besylate and Verapamil Hydrochloride.

Is Alcohol Good for High Blood Pressure?

It likely depends a lot on what else is going on with you.

First things first: Your best bets for lowering blood pressure are losing weight through diet and exercise, cutting sodium intake, and reducing stress.

But what if you enjoy a drink or two now and then? Light-moderate drinking (defined as up to two drinks a day for men, one for women) has shown a subtle drop in blood pressure in some cases. In small amounts, it has been shown to lower blood pressure by 2 to 4 mm Hg (millimeters of mercury) in women. Most experts agree, though, that does not show a significant enough drop to advise drinking for an entire population.

But what about those other benefits hailed for heart health — the red wine antioxidant effect and lowering cholesterol, for example?

You need to determine your lifestyle and genetic risk factors first, says Arthur Klatsky, MD, an investigator for Kaiser Permanente’s research division and formerly its chief of cardiology in Oakland, CA.

A lot of people shouldn’t drink at all for specific reasons — family history of alcoholism or heart or liver disease, he says. But if you have no hereditary risk factors, a glass (for women) or up to two (for men) may be justified, depending on your age.

“Adults above the age of 50 are at much higher risk of heart attack and stroke than they are of any possible harmful effects to light-moderate drinking,” Klatsky says. “So even if they have high blood pressure, they could see the health benefit from something like a glass of red wine a day.”

But if you’re younger than 50, particularly if you’re a woman, it’s not so clear. Studies have shown a rise in breast cancer risk in women under 50 from drinking alcohol. While most studies show this results from drinking more heavily (more than 1-2 drinks a day), Klatsky says some research indicates even light-moderate drinking could play a role in a younger woman’s risk of breast cancer.

“Generally a woman 35 or younger isn’t dealing with blood pressure or vascular issues,” Klatsky says. “But I would still advise against her drinking at all because of the other risks involved. The general rule is that young people are not better off light-moderate drinkers because their heart attack risk is pretty low and won’t see any benefits from drinking.”

The bottom line, Klatsky says, is you can’t make a drinking rule that applies broadly for people with high blood pressure.

“There can be benefits related to light-moderate drinking — like the antioxidant effect and cholesterol drop with red wine — but likely that’s not related to blood pressure,” Klatsky says. “Either beneficial or harmful, the decision from a medical viewpoint is that it depends on the person’s entire health profile.”

A Note for Red Wine Lovers

Research has not proven that wine is linked to lowering blood pressure, says James Beckerman, MD, a cardiologist at the Providence St. Vincent Heart Clinic in Portland, OR.

A Dutch study showed that heart-healthy nutrients called polyphenols in red wine help prevent heart disease, but not because of a drop in blood pressure. Research shows that the polyphenols improve the cells lining the blood vessels, and do improve blood flow and heart health. The jury is still out, though, on whether this could potentially improve high blood pressure in severe cases.

Klatsky agrees. “One glass of red wine isn’t going to improve your blood pressure,” he says. “Ultimately, it’s lifestyle changes: low salt, optimal weightand exercise, and medication if necessary.”

Do you shudder at the thought of giving up your vino altogether? If you’ve been advised against drinking for very high blood pressure, there may be salvation in one kind of wine: nonalcoholic.

One study found that three glasses of nonalcoholic red wine a day over a month led to a significant drop in blood pressure in men with heart disease risk factors. But men who drank red wine with alcohol, or 3 ounces of gin, had no change in their blood pressure. Researchers think that the alcohol in the wine weakens any antioxidant benefit to blood pressure.

Too Much of a Good Thing

Your age and other risk factors linked to heart and blood pressure health will ultimately aid your decision with your doctor about drinking. But don’t expect any “all clears” for anything beyond light-moderate drinking.

Having more than two drinks in a day may raise your blood pressure. Drinking more than one or two drinks in a sitting has been directly linked to a rapid rise in blood pressure, which in someone with very high levels of hypertension can lead to stroke.

“It doesn’t matter what beverage if you have a high risk, it’s all about the amount,” Klatsky says. “There’s plenty of research that shows heavy beer drinkers, heavy wine drinkers, it doesn’t matter, they are all at risk of increasing high blood pressure when drinking in excess.”

Klatsky says his biggest concern is that patients keep an open dialogue with their doctors about their lifestyle to achieve an authentic diagnosis.

“One rule doesn’t fit everyone,” he says, “so talk to your doctor about how your high blood pressure — and the rest of you — can determine your consumption choices.”

Does drinking alcohol affect your blood pressure

Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks in one sitting temporarily increases your blood pressure, but repeated binge drinking can lead to long-term increases.

Heavy drinkers who cut back to moderate drinking can lower their systolic blood pressure (the top number in a blood pressure reading) by 2 to 4 millimeters of mercury (mm Hg) and their diastolic blood pressure (the bottom number in a blood pressure reading) by 1 to 2 mm Hg.

 Heavy drinkers who want to lower blood pressure should slowly reduce how much they drink over one to two weeks. Heavy drinkers who stop suddenly risk developing severe high blood pressure for several days.

If you have high blood pressure, avoid alcohol or drink alcohol only in moderation. Moderate drinking is generally considered to be:

  • Two drinks a day for men younger than age 65
  • One drink a day for men age 65 and older
  • One drink a day for women of any age

A drink is 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof distilled spirits.

Keep in mind that alcohol contains calories and may contribute to unwanted weight gain — a risk factor for high blood pressure. Also, alcohol can interfere with the effectiveness and increase the side effects of some blood pressure medications.

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