Comparative Analysis of Hypertension Guidelines: Unveiling Consensus and Discrepancies in Lifestyle Modifications for Blood Pressure Control

Table 4

Summary of recommendations of alcohol restriction in guidelines.

Guideline	Alcohol restriction	Class of recommendation and level of evidence
2017 ACC [10]	Adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks per day, respectively	I A
	In individuals who drink alcohol, reduce alcohol to:
	(i) Men: ≤2 drinks daily. (ii) Women: ≤1 drink daily
	In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol)
2018 ESC [11]	It is recommended to restrict alcohol consumption to:	I A
	(i) Less than 14 units per week for men. (ii) Less than 8 units per week for women
	(1 unit is equal to 125 mL of wine or 250 mL of beer)
	It is recommended to avoid binge drinking	III C
2019 NICE [12]	Ask about people’s alcohol consumption and encourage a reduced intake if they drink excessively because this can reduce blood pressure and has broader health benefits	NA
2020 CAN [13]	In healthy adults, abstaining from alcohol or reducing alcohol intake to 2 drinks per day or less is recommended to prevent hypertension	Grade B
	In adults with hypertension who drink more than 2 drinks per day, a reduction in alcohol intake is associated with decreased BP and is recommended. In adults with hypertension who drink 6 or more drinks per day, a reduction in alcohol intake to 2 or fewer drinks per day is associated with decreased BP and is recommended	Grade A
2020 ISH [14]	Positive linear association exists between alcohol consumption, blood pressure, the prevalence of hypertension, and CVD risk. The recommended daily limit for alcohol consumption is 2 standard drinks for men and 1.5 for women (10 g alcohol/standard drink). Avoid binge drinking	NA