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Effect of alcohol on blood pressure : a systematic review and meta-analysis Tasnim, Sara


Background: Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This systematic review aimed to quantify the acute effect of different doses of alcohol on blood pressure (BP) and heart rate (HR) over time in the adult with both normal and raised blood pressure. We classified doses of alcohol into low (≤14 g alcohol), medium (>14g and ≤30g alcohol) and high (>30 g alcohol) based on the definition by Canadian Centre on Substance Use and Addiction. Objective: To quantify the magnitude of effect of acute alcohol consumption on blood pressure and heart rate in adults (≥18 years) during three different time periods: early, intermediate, and late. Method: We searched major databases (CENTRAL, MEDLINE, EMBASE) and other sources for randomized placebo-controlled trials (RCTs) comparing the effect of single-dose of alcohol with placebo on BP or HR in adults. Two authors independently extracted the data and assessed the quality of the studies. We used mean difference with 95% confidence interval to report effect size of outcome measures and a fixed effect model to combine the effect sizes across studies. Results: We included 32 RCTs involving 767 participants. Most of the study participants were healthy males (N=642) with a mean age of 33 years. Compared to placebo, low dose alcohol consumption had no significant early effect on BP but increased HR by 5 beats per minute (bpm). Effect of medium dose of alcohol on BP during the early period was -5.6/-4.0 mmHg and increase in HR was 4.6 bpm. The effect of high dose alcohol on mmHg BP was biphasic: early (-3.5/-1.9) intermediate (-3.7/-1.6) and late (3.7/2.4). HR in bpm was increased at all time periods: early 5.8, intermediate 6.2 and late 2.7. Conclusion: Compared to placebo alcohol causes a decrease in BP and increase in HR during the early and intermediate time periods (up to 12 hours) after alcohol consumption. Between 13 and 24 hours after consumption both blood pressure and heart rate are increased.

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