Numerous studies have shown a relationship between alcohol intake and elevated clinic blood pressures (BP). However, there have been few studies on the relationship between alcohol consumption and 24-h ambulatory BP monitoring. This study aimed to determine the relationship between alcohol intake, clinic BP, and 24-h ambulatory BP recordings to determine to what extent a white coat effect may contribute to the relationship between alcohol consumption and BP. Clinical BP and 24-h ambulatory BP were measured in 121 male volunteers aged 50.6 +/- 9.8 years (range, 30-70 years) who consumed between 0 and 2050 g of alcohol per week (mean, 394 +/- 342 g; median, 385 g/week). Supine clinical systolic BP (SBP) was significantly related to alcohol intake (beta = 0.242; P = .007). Alcohol consumption was not related to 24-h mean SBP or diastolic BP (DBP), daytime SBP or DBP, or nighttime SBP or DBP (daytime SBP: beta = 0.02, P = .802). Alcohol intake was significantly related to the difference between clinic SBP and mean daytime SBP (beta = 0.260, P = .004). Twenty-four-hour mean heart rate (HR), daytime mean and nighttime mean HR were strongly associated with alcohol intake (24-h HR: beta = 0.455, P < .001). These results suggest that the association between alcohol consumption and elevated BP is contributed to by a significant white coat effect and that excessive alcohol consumption may be a significant factor in explaining differences between clinic and ambulatory BP measurements.