['Despite criticism of self-reported alcohol intake, it is a valuable tool to screen for alcohol abuse as a risk factor for cardiovascular disease. We aimed to compare various self-reported estimates of alcohol use with γ-glutamyltransferase (GGT) and percentage carbohydrate deficient transferrin (%CDT) considering their relationship with blood pressure changes (%BP) over a 5-year period in black South Africans.', "We recruited 1994 participants and collected 5-year followed up data (N\u200a=\u200a1246). Participants completed questionnaires on alcohol intake indicating their former and current alcohol use ('yes' response and 'no' if alcohol was never used). We assessed alcohol intake (in g) using a quantified food frequency questionnaire. We collected blood samples and measured GGT and %CDT. Brachial BP (bBP) was measured at baseline and follow-up and central BP (cBP) at follow-up only.", 'Self-reported alcohol intake was significantly associated with the 5-year change in bBP before and after adjusting for confounders (%bSBP: R(2)\u200a=\u200a0.263, β\u200a=\u200a0.06, P\u200a=\u200a0.023; %bDBP: R(2)\u200a=\u200a0.326, β\u200a=\u200a0.08 P\u200a=\u200a0.005), as well as cSBP (R\u200a(2)=\u200a0.286, β\u200a=\u200a0.09, P\u200a=\u200a0.010) and central pulse pressure (R(2)\u200a=\u200a0.254, β\u200a=\u200a0.06, P\u200a=\u200a0.020). GGT and %CDT correlated well with self-reported alcohol intake (r\u200a=\u200a0.44; P\u200a=\u200a0.001; r\u200a=\u200a0.34 P\u200a=\u200a0.001), but did not associate significantly with %bBP or cBP at follow-up.'] Is self-reported alcohol intake a better estimate of 5-year change in blood pressure than biochemical markers in low resource settings : the PURE study?