Obesity and high blood pressure are both aspects of poor metabolic health, or dysfunction in your body’s ability to regulate blood sugar, fats, and inflammation. The two conditions are therefore closely linked.
“Being overweight, especially around the belly, is one of the biggest risk factors for high blood pressure,” says Raghuveer Vedala, MD, a family medicine and obesity specialist at Norman Regional Hospital System in Oklahoma City and a member of the Obesity Medicine Association.
Alcohol makes this interaction even worse. If you are overweight or obese, for example, even light alcohol consumption can significantly increase your risk of high blood pressure: the combined risk is greater than just adding the individual risks of being overweight and drinking.
Although you may have already heard that a little red wine protects your heart health, experts today increasingly agree that there are no benefits to drinking alcohol, only harms. Alcohol consumption, especially excessive drinking, aggravates conditions such as obesity and high blood pressure.
Alcohol and obesity
Alcohol exacerbates obesity by adding empty calories that promote fat storage, increasing hunger and cravings, and disrupting sleep quality.
Alcohol is toxic to the liver, which plays a vital role in metabolic health. Even low or moderate alcohol consumption is associated with greatly increased risks of liver diseases MASLD and MASH. These conditions are defined by a dangerous accumulation of fat in the liver. They are common in obese people.
When people with MASLD drink moderately, their risk of advanced liver disease may be as high as the risk experienced by people with alcohol use disorders.
And for many people, alcohol promotes weight gain simply because it’s a high-calorie drink.
“Alcohol has the highest number of calories per gram after fat,” says Dr. Vedala. There are 7 calories per gram of alcohol and 9 calories per gram of fat. But unlike fat, alcohol doesn’t provide many nutrients and doesn’t trigger the same satiety signals as nutrient-dense foods.
Research shows that heavy drinking – defined as eight or more drinks per week for women and 15 or more drinks per week for men – is consistently linked to weight gain.
Additionally, alcohol can lower inhibitions, making impulsive eating more likely. “Over time, this can lead to weight gain, especially around the waist,” says Vedala. This fat, which surrounds organs like the heart and liver, has an outsized effect on cardiovascular health.
Alcohol and high blood pressure
Drinking alcoholic beverages – even if it’s just one drink a day – can increase blood pressure.
When you drink alcohol, the sympathetic nervous system, which triggers your “fight or flight” response to stress, intensifies. This triggers the kidneys to tighten control of blood pressure signals and causes inflammation that interferes with the natural relaxation of blood vessels, says Dr. Garcia-Webb. As a result, your blood pressure increases.
This increase in blood pressure can be both immediate and chronic. Even moderate drinking – two drinks or less per day for men and one drink or less per day for women – can increase blood pressure if done daily, says Vedala.
Whether you’re a heavy or light drinker, the more you drink, the more your blood pressure will tend to rise.
“Even though one drink may cause a short-term spike, regular consumption activates stress hormones and leads to a sustained increase in blood pressure,” says Vedala.
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