Alcohol Consumption and the Risk of Hypertension in Women and Men

Abstract

Abstract-Heavy alcohol intake increases the risk of hypertension, but the relationship between light-to-moderate alcohol consumption and incident hypertension remains controversial. We prospectively followed 28 848 women from the Women's Health Study and 13 455 men from the Physicians' Health Study free of baseline hypertension, cardiovascular disease, and cancer. Self-reported lifestyle and clinical risk factors were collected. In women, total alcohol intake was summed from liquor, red wine, white wine, and beer; men reported total alcohol intake from a single combined question. During 10.9 and 21.8 years of follow-up, 8680 women and 6012 men developed hypertension (defined as new physician diagnosis, antihypertensive treatment, reported systolic blood pressure Ն140 mm Hg, or diastolic blood pressure Ն90 mm Hg). In women, we found a J-shaped association between alcohol intake and hypertension in age-and lifestyle-adjusted models. Adding potential intermediates (body mass index, diabetes, and high cholesterol) attenuated the benefits of alcohol in the light-to-moderate range and strengthened the adverse effects of heavy alcohol intake. Beverage-specific relative risks paralleled those for total alcohol intake. In men, alcohol intake was positively and significantly associated with the risk of hypertension and persisted after multivariate adjustment. Models stratified by baseline systolic blood pressure (Ͻ120 versus Ն120 mm Hg) or diastolic blood pressure (Ͻ75 versus Ն75 mm Hg) did not alter the relative risks in women and men. In conclusion, light-to-moderate alcohol consumption decreased hypertension risk in women and increased risk in men. The threshold above which alcohol became deleterious for hypertension risk emerged at Ն4 drinks per day in women versus a moderate level of Ն1 drink per day in men. Key Words: alcohol Ⅲ hypertension Ⅲ blood pressure Ⅲ prospective study Ⅲ men Ⅲ women C onsiderable evidence supports an association between excessive alcohol intake and an increased risk of hypertension. [1][2][3] This association persists regardless of beverage type, 4 implicating ethanol in this etiologic process, although few studies have compared beverage types. 5,6 A meta-analysis of randomized clinical trials among subjects initially consuming 3 to 6 drinks per day found that reductions in alcohol intake significantly decreased both systolic and diastolic blood pressure (BP; SBP and DBP, respectively). 7 Clinically meaningful BP reductions occur within weeks after reductions in alcohol intake among hypertensive subjects, 8 but few data exist among normotensive individuals.Clinical guidelines on the primary prevention of hypertension recommend limiting alcohol intake Յ2 drinks per day in men and Յ1 drink per day in women. 9,10 However, uncertainty remains regarding any benefits or risks attributable to light-to-moderate alcohol intake on the risk of hypertension. Conflicting studies have noted beneficial, 6 unassociated, 2,3,5,11 and deleterious 12,13 effects on the risk of hypertension or elevations in BP. ...

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

“…In total, data from 20 reports from 18 studies were used in the analysis (Figure 1). Nine reports were from the United States,22, 23, 24, 42, 43, 44, 45, 46, 47 4 from Japan,48, 49, 50, 51 2 from China,52, 53 and 1 each from Germany,54 South Korea,55 Finland,56 Turkey,57 and Thailand58 (Table). Several reports from the Nurses’ Health Study42, 44, 45, 46 were included, but any 1 case of incident hypertension was included only once in any particular analysis.…”

Alcohol Consumption and the Incidence of Hypertension in a Mediterranean Cohort: The SUN Study

“…Nuestros resultados sostienen indirectamente la hipótesis de que hay un efecto beneficioso del vino en comparación con otras bebidas alcohólicas respecto a la prevención de la enfermedad cardiovascular y la mortalidad 34 . Acorde con nuestros resultados, en un reciente estudio de cohortes se ha observado un incremento significativo del riesgo de hipertensión sólo con el consumo de cerveza, licores y vino blanco, mientras que el consumo de vino tinto no mostró ningún efecto significativo 9 .…”

“…Se ha señalado que el riesgo de hipertensión asociado a un consumo elevado de alcohol es independiente del tipo específico de bebida alcohólica consumida 8 . Sin embargo, en un reciente estudio de cohortes, se observaron elevaciones significativas del riesgo de hipertensión solamente en las categorías más altas de consumo de cerveza, licor y vino blanco, pero no de vino tinto 9 . Además, la influencia del patrón de consumo de alcohol, incluyendo los tipos específicos de bebida, en el riesgo de hipertensión arterial no se ha estudiado de modo prospectivo en una población mediterránea, en la que a priori el mayor consumo de vino y la consecuentemente mayor variación de dicho consumo entre sujetos permitiría valorar mejor su efecto.…”

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

“…[1][2][3][54][55][56][57][58] These associations have been observed regardless of race, gender, age and the type of alcohol ( Figure 2). Although some studies suggest the presence of a threshold regarding the pressor effect of alcohol, 59,60 the relationship between the level of alcohol consumption and BP is usually linear. In cross-sectional studies, the systolic BP increased by 3-4 mm Hg and diastolic BP increased by 1-2 mm Hg per three drinks per day (one drink contained 10-15 ml, or 8-12 g of alcohol).…”