A systematic review and meta-analysis 1 assessing the effect of a reduction in alcohol consumption on change in blood pressure included 36 trials with 2 865 participants (2 464 men and 401 women). In people who drank 2 or fewer drinks per day, a reduction in alcohol was not associated with a significant reduction in blood pressure; however, in people who drank more than 2 drinks per day, a reduction in alcohol intake was associated with increased blood pressure reduction. Reduction in systolic blood pressure (mean difference -5.50 mmHg, 95% CI -6.70 to -4.30) and diastolic blood pressure (-3.97 mmHg, 95% CI -4.70 to -3.25) was strongest in participants who drank 6 or more drinks per day if they reduced their intake by about 50%. For the UK, the results would translate into more than 7000 inpatient hospitalisations and 678 cardiovascular deaths prevented every year.
A systematic review 2 included 4 studies with a total of 496 subjects. The mean difference (MD) in systolic blood pressure with alcohol restriction was -3.8 (95% CI -6.1 to -1.4) and the MD in diastolic blood pressure was -3.2 (95% CI -5.0 to -1.4).
Comment: The quality of evidence is downgraded by study limitations (inadequate allocation concealment, inadequate randomization) and upgraded by clear dose-response gradient.
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