Abstinence or limiting alcohol intake may lead to clinically meaningful blood pressure reductions

Light-to-moderate alcohol consumption is associated with increases in blood pressure (BP) and stopping drinking – even drinking less – may lead to clinically meaningful BP reductions, according to a study published today in JACC, the flagship journal of the American College of Cardiology. Findings show that slight changes in alcohol consumption can affect BP and can be a strategy for BP management and improvement.

Alcohol consumption is a well-established contributor to elevated BP, a major risk factor for cardiovascular disease (CVD). The 2025 ACC/AHA High Blood Pressure Guideline recommends nonpharmacological management strategies for high BP, including abstinence or limiting alcohol intake to one or fewer drinks (12–14 g) daily for women and two or fewer drinks daily for men. However, the impact of changes in light-to-moderate drinking habits – particularly cessation – on BP has remained unclear, especially among women and different beverage types.

Our study set out to determine whether stopping alcohol use is associate with improvement in BP levels among habitual drinkers and whether starting alcohol use affects BP among non-habitual drinkers. We focused on understudied groups, particularly women, light-to-moderate drinkers and consumers of different beverage types, to better understand how even low levels of alcohol consumption influence BP management, a critical public health issue."

Takahiro Suzuki, MD, MPH, lead author of the study from St. Luke's International Hospital and the Institute of Science Tokyo

In this longitudinal annual check-up analysis from Japan, researchers analyzed 359,717 annual health check-up visits from 58,943 adults (52.1% women; median age 50.5 years) from 2012 to 2024. Alcohol intake was self-reported and categorized by standard drinks per day. The study tracked changes in systolic and diastolic blood pressure between visits, using a statistical model that accounted for demographics, medical history and lifestyle factors.

Study participants were divided into two cohorts: 1) habitual drinkers at first visit and 2) non-drinkers at first visit. Cohort 1 was created to understand the association between BP changes and alcohol cessation or continued habitual drinking, and Cohort 2 was created to understand the association between BP changes and new onset drinking or no drinking at the following visit.

Among participants who stopped drinking, lower BP was observed based on drinking level. Women who stopped drinking one to two drinks per day saw a decrease of 0.78 mmHg in systolic BP and 1.14 mmHg in diastolic BP. Men who stopped drinking at similar levels experienced reductions of 1.03 mmHg and 1.62 mmHg, respectively. Conversely, participants who initiated alcohol consumption showed higher BP based on drinking level, with similar trends across sexes.

Beverage-specific analyses revealed that the type of alcohol (beer, wine or spirits) did not significantly alter the BP effects, suggesting that quantity of alcohol intake is the primary driver of BP changes rather than beverage-specific components.

"Our study shows that when it comes to BP, the less you drink, the better. The more alcohol you drink, the higher your BP goes. In the past, scientists thought that small amounts of alcohol might be okay, but our results suggest that no alcohol is actually best. This means that stopping drinking, even at low levels, could bring real heart health benefits for both women and men," Suzuki said.

Harlan Krumholz, MD, FACC, JACC Editor-in-Chief and Harold H. Hines Jr Professor of Medicine, Yale University School of Medicine, noted that the results challenge long-standing assumptions that low levels of alcohol do not meaningfully affect blood pressure.

"These findings suggest that alcohol cessation, even from low levels, could prevent or treat hypertension," Krumholz said. "This is especially important as treatment targets for BP have been lowered."

Study limitations include its observational design, which prevents establishing definitive cause-and-effect relationships. While researchers adjusted for many lifestyle and health factors, unmeasured influences, like changing drinking habits or detailed sodium and potassium intake, may have affected results. Alcohol consumption was self-reported, which can introduce recall bias, though standardized questionnaires improved accuracy. Additionally, the study population was predominantly Japanese and urban, which may limit generalizability to other groups.