Effect of alcohol withdrawal on blood pressure, plasma renin activity, aldosterone, cortisol and dopamine β-hydroxylase

Bannan, L T; Potter, JF; Beevers, D. G.; Saunders, John B.; Walters, J. R. F.; Ingram, M

doi:10.1042/cs0660659

Cited by 73 publications

(40 citation statements)

References 11 publications

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“…This is at variance to some previous anecdotal suggestions 19,20 of participation of an activated renin-angiotensin-aldosterone system in HTN of alcoholics. Instead of consistent elevations in PRA, more accurate studies showed a trend to a fall in PRA from high-normal levels toward suppressed values in short-to medium-term withdrawing alcoholics, [21][22][23][42][43][44] a finding that may be related to the recovery from a previous dehydrated state. 23,43,44 Abnormal changes of both BP and PRA to alteration in Na intake, such as those observed in alcoholics, are typically associated with salt sensitivity in essential HTN.…”

Section: Gennaro Et Al Sodium Sensitivity and Alcoholism 871mentioning

confidence: 97%

Sodium Sensitivity of Blood Pressure in Long-Term Detoxified Alcoholics

et al. 2000

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Abstract-To investigate whether sodium sensitivity of blood pressure participates in the relationship of arterial hypertension to chronic alcohol consumption, 30 alcoholics detoxified from 6 to 12 months and 30 teetotaler controls underwent a dietary sodium manipulation study. They received a daily 55 mmol sodium diet for 7 days, followed by a 260 mmol sodium diet for 7 days. Changes in 24-hour urinary sodium excretion between the end of each period were similar in alcoholics and controls (202Ϯ16 SEM mmol and 227Ϯ11, respectively). Plasma renin activity in alcoholics was lower than in controls at both low (2.4Ϯ0.4 ng angiotensin I/mLϫh -1 versus 3.7Ϯ0.2, PϽ0.003) and high sodium intake (0.47Ϯ0.10 versus 0.82Ϯ0.10, PϽ0.05), with smaller variations in alcoholics (Ϫ1.9Ϯ0.3 versus Ϫ2.9Ϯ0.2, PϽ0.009). In alcoholics, alteration in sodium intake was followed by greater changes in both systolic and mean blood pressure (ambulatory blood pressure monitoring), which rose by 10.6Ϯ2.2 mm Hg and 7.3Ϯ1.5 versus 4.7Ϯ1.4 and 3.9Ϯ1.0 in controls, respectively (PϽ0.03 for systolic and PϽ0.05 for mean blood pressure). The ratio of changes in mean blood pressure to those in 24-hour urinary sodium excretion was higher in alcoholics (0.044Ϯ 0.011 mm Hgϫmmol Ϫ1 versus 0.018Ϯ0.0041, PϽ0.005). Our data show that in detoxified alcoholics, there is an abnormal response of both blood pressure and plasma renin activity to variations in salt intake similar to that in sodium-sensitive arterial hypertension. The precise relationship between the sodium sensitivity of blood pressure in detoxified alcoholics and the long-term influence of alcohol on blood pressure remains to be elucidated. Key Words: alcoholism Ⅲ blood pressure Ⅲ sodium sensitivity A n association between chronic exposure to alcoholic beverages and elevation in blood pressure (BP) has been widely recognized. 1Ϫ6 Cross-sectional and epidemiological reports have indicated that chronic consumption of alcohol equal to 3 drinks per day or more may be an independent variable that acts on BP (in addition to obesity, Na intake, smoking, physical activity, age, gender, and race), with a magnitude similar to that observed for obesity and even greater than that of Na intake by itself. 2,3,5 Studies in moderate drinkers and chronic alcoholics have also shown a relationship between current alcohol intake and BP, 6 -10 although no further increase in BP was detected over a daily alcohol intake of 6 drinks per day. 2,4,10 Furthermore, prospective studies have indicated that alcohol consumption was accompanied by increasing BP over time and by an elevated risk of developing clinical arterial hypertension (HTN). 1,4,5,11 Finally, intervention studies in alcoholics have almost invariably shown a significant decrease in BP with reduced or no alcohol exposure. 12Ϫ16 Several investigations on the mechanisms that underlie the link between chronic alcohol consumption and HTN have been conducted involving, as the candidate abnormalities genetic predisposition, 10 hyperdynamic circulation with high cardia...

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Section: Gennaro Et Al Sodium Sensitivity and Alcoholism 871mentioning

confidence: 97%

Sodium Sensitivity of Blood Pressure in Long-Term Detoxified Alcoholics

et al. 2000

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“…26 The pressor response during alcohol withdrawal reaches a peak the day after cessation. 39 In this case, the BP decreased to a lower level compared with baseline within several days after alcohol withdrawal in heavy drinkers. 40 As habitual drinkers experience a mild degree of repeated alcohol withdrawal in daily life, it is possible that this withdrawal phenomenon contributes to alcohol-related hypertension.…”

Section: Alcohol Withdrawal Syndromementioning

confidence: 99%

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

Kawano

2010

Hypertens Res

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Alcohol has complex effects on the cardiovascular system. The purpose of this article is to review physio-pathological effects of alcohol on cardiovascular and related systems and to describe its role in hypertension and cardiovascular disease. The relationship between alcohol and hypertension is well known, and a reduction in the alcohol intake is widely recommended in the management of hypertension. Moreover, alcohol has both pressor and depressor actions. The latter actions are clear in Oriental subjects, especially in those who show alcohol flush because of the genetic variation in aldehyde dehydrogenase activity. Repeated alcohol intake in the evening causes an elevation in daytime and a reduction in nighttime blood pressure (BP), with little change in the average 24-h BP in Japanese men. Thus, the hypertensive effect of alcohol seems to be overestimated by the measurement of casual BP during the day. Heavy alcohol intake seems to increase the risk of several cardiovascular diseases, such as hemorrhagic stroke, arrhythmia and heart failure. On the other hand, alcohol may act to prevent atherosclerosis and to decrease the risk of ischemic heart disease, mainly by increasing HDL cholesterol and inhibiting thrombus formation. A J-or U-shaped relationship has been observed between the level of alcohol intake and risk of cardiovascular mortality and total mortality. It is reasonable to reduce the alcohol intake to less than 30 ml per day for men and 15 ml per day for women in the management of hypertension. As a small amount of alcohol seems to be beneficial, abstinence from alcohol is not recommended to prevent cardiovascular disease. INTRODUCTIONAlcohol has complex effects on the cardiovascular system. The relationship between alcohol and hypertension is well known, and a restriction of alcohol intake is widely recommended as a part of lifestyle modifications in the management of hypertension. 1-6 Alcohol has both pressor and depressor actions, however, and the genetic susceptibility regarding alcohol metabolism influences the cardiovascular effect of alcohol. 3,7 The effect of alcohol on blood pressure (BP) is also modified by several factors, such as the level of consumption, time period after the last drink and overall drinking behavior.Alcohol consumption is associated with several cardiovascular diseases, such as brain hemorrhage, heart failure and arrhythmia, as well as with other disorders. 3,[8][9][10][11] Heavy drinking and alcoholism not only lead to medical problems but are also serious social concerns. However, alcohol also seems to have beneficial effects, including the prevention of ischemic heart disease. It has been shown that cardiovascular and all-cause mortality is lower in light drinkers compared with nondrinkers. 3,[8][9][10][11][12] The purpose of this article is to review physio-pathological effects of alcohol on cardiovascular and related systems and to describe its role

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“…The degree of blood pressure elevation was found to be related to the severity of alcohol withdrawal in heavy drinkers during detoxification. 44 Subsequently, it was suggested that long-term alcohol consumption leads to a state of intermittent withdrawal even at low levels of consumption 45 that may be responsible for the elevation in blood pressure. This hypothesis is consistent with observation in the LRC Prevalence Study 7 that blood pressure (measured after 12 hours of fasting) was more closely associated with alcohol consumed in the previous 24 hours than with alcohol consumed in the previous week.…”

Section: Possible Mechanismsmentioning

confidence: 99%

Alcohol consumption and hypertension.

MacMahon¹

1987

Hypertension

366

147

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SUMMARY An increased prevalence of hypertension in groups with high alcohol consumption has been recognized for a number of years. More recently, several studies have suggested an independent association between alcohol consumption and blood pressure levels in samples from general populations. Of 30 cross-sectional population studies reviewed, the majority reported small but significant elevations in blood pressure in those consuming three drinks or more per day in comparison with nondrinkers. In 25% of studies, elevations in blood pressure were also reported at lower levels of consumption; in about 40%, the blood pressure of nondrinkers was greater than that of those consuming one to two drinks per day. In two studies, one from the United States and one from Australia, the maximum contribution to the prevalence of hypertension of alcohol consumption greater than two drinks per day was estimated to be 5 to 7%; the contribution in men (11%) was greater than that in women because of their greater alcohol consumption. A prospective association of alcohol consumption with change in blood pressure was observed in five studies. In a small number of experimental studies, short-term falls in blood pressure accompanied alcohol restriction in both normotensive and hypertensive subjects. Uncontrolled observations in heavy drinking populations suggest that the effect on blood pressure of alcohol withdrawal may be lasting. However, firm conclusions about the long-term effects of alcohol restriction, particularly in moderate consumers who represent a large proportion in many populations, must await long-term controlled trials. In the past 20 years attention has focused on the question of whether an association exists between alcohol consumption and blood pressure levels in wider populations not selected on the basis of alcohol intake. This question has been addressed in a large number of cross-sectional studies and in a smaller number of prospective studies conducted in populations from a variety of geographic regions, including North America, Europe, Australia, New Zealand, and Japan.The present report reviews the epidemiological evi- dence for the existence of an association between blood pressure and levels of alcohol consumption. Evidence is also considered concerning the nature of the association, that is, whether the association is linear or nonlinear and whether a consumption threshold exists for blood pressure elevation. These issues bear on the important public health question of the extent to which alcohol consumption contributes to blood pressure elevation in the population.Two other questions are also considered. The first concerns the effects on blood pressure of modification of alcohol intake. This issue has been investigated in a small number of recent trials in hypertensive and normotensive subjects. The second question concerns the mechanism(s) by which alcohol affects blood pressure; a small number of studies in animals and in humans have attempted to address this question. For neither question are the avai...

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Effect of alcohol withdrawal on blood pressure, plasma renin activity, aldosterone, cortisol and dopamine β-hydroxylase

Cited by 73 publications

References 11 publications

Sodium Sensitivity of Blood Pressure in Long-Term Detoxified Alcoholics

Sodium Sensitivity of Blood Pressure in Long-Term Detoxified Alcoholics

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

Alcohol consumption and hypertension.

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