The present analyses addressed the relationship between alcohol consumption, drinking patterns and hypertension in 6699 Italian men and women participating in a national project on arteriosclerosis risk factors. The results of the analyses are consistent with an association between heavy alcohol consumption and systolic blood pressure in both males and females. Higher diastolic blood pressure was associated with heavy alcohol consumption in men but not in women. Drinkers of wine both with and without meals have a higher prevalence of hypertension than abstainers in both sexes. We conclude that heavy alcohol consumption is associated with higher blood pressure values, and that the pattern of drinking could be an important determinant in the association between alcohol and hypertension.