Key Points: 1. Several studies have linked alcohol intake and hypertension. 2. Possible underlying causes that have been discarded include obesity, salt, cigarettes, and coffee. Proposed mechanisms include increased corticosteroid levels, a hypermetabolic state, direct effects of alcohol on the cardiovascular system, and on the central nervous and autonomic nervous systems. 3. There is a positive correlation between alcohol use and strokes; there is an inverse relation to coronary heart disease. 4. Hypertension control advice should include restriction of alcohol intake to less than three drinks daily.