OBJECTIVE This study investigated the relation between alcohol consumption and the risk of cardiovascular disease (CVD) among 10 530-hypertensive women from the EPIC-NL cohort. RESULTS Alcohol consumption was assessed using a validated food-frequency questionnaire and participants were followed for occurrence of CVD. During 9.4 years follow-up, we documented 580 coronary heart disease (CHD) events and 254 strokes, 165 of which were ischemic. An inverse association (Ptrend=0.009) between alcohol consumption and risk of CHD was observed with a multivariate-adjusted hazard ratio of 0.72 (95% confidence interval: 0.52-1.01) for those consuming 70-139.9 g alcohol/week compared to lifetime abstainers. Of different beverages, only red wine consumption was associated with a reduced risk of CHD. A U-shaped relation (P=0.08) was observed for total stroke with a hazard ratio of 0.65 (0.44-0.95) for consuming 5-69.9 g alcohol/week compared with lifetime abstainers. Similar results were observed for ischemic stroke with a hazard ratio of 0.56 (0.35-0.89) for consuming of 5-69.9 g alcohol/week. CONCLUSIONS We conclude that moderate alcohol consumption is associated with a reduced risk of CHD among hypertensive women. Light alcohol consumption tended to be related to a lower risk of stroke. Current guidelines for alcohol consumption in the general population also apply to hypertensive women.