The risk of hypertension seems to already increase with low levels of alcohol consumption. But are there possible differences for gender, race and alcoholic beverage? A recent meta-analysis finds that men and black people are at higher risk of hypertension with moderate alcohol consumption. Results also suggest that the risk of hypertension is higher when drinking liquor compared to wine and beer.
What is already known? Heavy alcohol consumption increases the risk of hypertension, but the effect of moderate alcohol consumption is less clear. A meta-analysis2 from 2018 found that for men, any amount of alcohol increases the risk of hypertension, and that the risk for women increases after two drinks a day. A more recent meta-analysis3 found that the risk for Asian men indeed increased with less than two drinks a day, but for Western men, there was no significant increase for moderate alcohol consumption.

What does this study add? This study systematically assesses the relation between alcohol consumption and hypertension, and analyzes whether there are gender, race and beverage specific differences. The analysis includes 31 studies with over 400,000 participants.

Higher risk for men
This meta-analyses confirms what previous studies already found; there is a difference in risk of hypertension due to alcohol consumption per gender. The results show that at one alcoholic consumption a day (10 grams alcohol), the risk for men increases by approximately 14%.

For women, there is no increased risk at this low level of consumption. The risk does however increase with 30 grams a day. An older meta-analysis4 found a protective association of moderate alcohol consumption for women, but the current analysis finds no evidence for that.

Higher risk among black people
Looking at a possible role of race, it seems that black people have a higher risk to develop hypertension with alcohol consumption compared to white and Asian people. With about half a glass a day (6 grams alcohol), the risk increases with 8%, and with 4,5 glasses a day the risk increases as much as 78%. For Asian and white people, these percentages are lower; 3% for half a glass and approximately 27% for 4,5 glasses.

Why the risk is higher for black people is not fully understood. The authors mention that it could be due to the fact that socioeconomic status, educational level, family income, and racial inequality result in psychological distress, which is related to hypertension. These psychosocial effects may be stronger than the alcohol effect.

Higher risk with liquor
The risk of hypertension slightly decreases with a low level of wine and beer consumption (up to one drink a day) compared with non-drinkers. But with more than 1,5 glass a day (15 grams of alcohol), the risk increases fast. With liquor, the risk already increases at low levels of consumption.


  • Many studies included
  • Subgroup analyses performed
  • Dose-response analysis
  • Differentiation between type of beverage
  • Sensitivity analysis excluding studies that did not separate ex-drinkers


  • Observational studies – cannot prove causality

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