Alcohol and cannabis can impact blood pressure and medications. Learn how to make informed choices for heart health and talk openly with your doctor.

Published: May 12, 2025

Estimated reading time: 5 minutes

You’ve heard the usual heart health advice — exercise more, cut the salt, maybe swap the fries for a salad. But no one talks about your weekend wine and cocktails, that edible you split with a friend or the vape pen tucked in your drawer. Let’s go there.

Many adults enjoy alcohol or use cannabis products for a variety of reasons. They may use these as ways to relax, but did you know that these substances can raise blood pressure? Here’s what you need to know about how alcohol and cannabis may raise blood pressure in adults.* 

Alcohol is a buzzkill for your liver

Alcohol is processed by the liver, which can handle only so much at a time. Too much alcohol can damage the liver over time. Drinking too much alcohol — beer, wine, or liquor — can raise the force your blood exerts on your arteries. What is “too much”? As with many substances, the poison is in the dose, which means — it depends on how much, your size, gender and age.

“We process alcohol differently as we age,” said Joshua H. Brandon, M.D., family medicine physician with Norton Community Medical Associates. “Men and women handle alcohol differently. Medications also can impact how your body responds to alcohol.” 

Moderate drinking is considered to be two drinks or less in a day for men and one drink or less for women. Binge drinking means four or more drinks for women, or five or more drinks for men during an occasion. Heavy drinking means eight or more drinks for women, or 15 or more drinks for men during a week.

A “drink” is:

• 12 ounces of beer with 5% alcohol
• 8 ounces of malt liquor with 7% alcohol
• 5 ounces of wine with 12% alcohol
• A shot or 1.5 ounces of liquor or distilled spirts (80-proof liquor)
  • 80 proof means the liquor has 40% alcohol.
  • Types of liquor include brandy, gin, rum, tequila vodka, and whiskey.

“Even moderate alcohol consumption can interfere with blood pressure medication,” Dr. Brandon said. 

According to the National Institute on Alcohol Abuse and Alcoholism: 

• Alcohol can alter the metabolism of a medication, speeding or slowing the clearance of the medication from the body and thus lowering or raising the blood levels of the medication.
• A medication can influence the absorption and metabolism of alcohol, potentially resulting in higher blood alcohol concentrations (BACs) and other adverse effects. 
• Alcohol can alter the pharmacological effects of the medication, which can increase or decrease the effect of the medication on the body.

Cannabis is not a chill as you might think (at least for your heart)

Tetrahydrocannabinol (THC) is the primary active compound in cannabis. It’s what gives users a “high.” THC can cause temporary spikes in heart rate and blood pressure. How your body responds to THC depends on several factors, including:

• Dose
• Method — smoking, gummies, edibles
• Overall health, including the presence of chronic conditions
• The presence of other substances, such as medications, alcohol, or tobacco
• Age
• Frequency and duration of use

The side effects of cannabis taken with blood pressure medication include:

• Marijuana’s biggest-known impact is with opioids, sleep medications, muscle relaxants and alcohol, because all affect the central nervous system. Marijuana use combined with these may boost the effects of both.
• Marijuana may increase the risk of bleeding when taken with drugs that increase the risk of bleeding, such as aspirin, blood thinners or other pain relievers, including ibuprofen and naproxen.
• Marijuana may affect blood sugar levels. If you are taking medication or insulin for diabetes, you should be watched closely by a health care provider.  
• Marijuana may cause low blood pressure, which may affect people on high blood pressure medication. 

As cannabis becomes legal in more places, both for recreational use and for medical purposes, people should stay informed about the potential health risks. One small study showed a moderate increase in systolic blood pressure with cannabis use. The general consensus is more research is needed, especially in older adults. 

Blood pressure and substance use

High blood pressure is referred to as a “silent killer,” due to the lack of symptoms. Long-term high blood pressure increases the risk of heart attack, heart disease, stroke and kidney disease.

• High blood pressure is often symptom-free — hence “the silent killer.”
• Long-term high blood pressure  increases risk of heart attack, stroke and kidney disease.
• Alcohol and cannabis can make it harder to manage or detect changes in blood pressure.
• Getting blood pressure checked regularly is key — even if you feel fine.

No judgment, just things to know:

• Your first step should be awareness. Get a baseline blood pressure reading with your health care provider at your annual checkup. Keep track of your blood pressure using an at-home monitor. Check your blood pressure after alcohol consumption or cannabis use. 
• Be honest with your health care provider so they can give you the best care and offer options to keep you safe and healthy. This may help you make smarter choices for your health. 
• Little tweaks can add up, and your doctor can help by adjusting medications or explaining how much to cut back. 

Checking in with your heart

Heart health isn’t about giving up things you enjoy; it’s about understanding how your lifestyle may affect your health. Talk to your doctor honestly about your drinking, even if it’s an uncomfortable topic.

“It is important for your health care provider to know if you are using alcohol or cannabis, even if it’s moderate use,” Dr. Brandon said. “There may be potentially harmful interactions that you don’t know about.” 

*Disclaimer: Recreational cannabis use is currently illegal in Kentucky and Indiana.