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Seven alcoholic drinks per week enough to increase odds of hypertension
NEW ORLEANS — Moderate and heavy alcohol drinkers appear to have an increased prevalence of both stage 1 and stage 2 hypertension, according to a presentation at the American College of Cardiology Scientific Session.
In the study, moderate drinkers reported consuming at least seven drinks per week, and heavy drinkers at least 14 drinks per week.
“Epidemiological studies have shown the association between the source of alcohol consumption and hypertension,” Amer Ismil Aladin, MD, FACP, FAAFP, a cardiology fellow at Wake Forest Baptist Health in Winston-Salem, North Carolina, said during a web briefing. “However, we know that the association between a more moderate level of alcohol consumption and hypertension are less well-established, so far.”
Aladin said the purpose of the study was to examine the association between alcohol consumption and prevalence of elevated BP, stage 1 and stage 2 hypertension in a large, representative national cohort. The researchers analyzed 17,059 participants from the National Health and Nutrition Examination Survey (mean age, 46 years; 40% white; 53% women). Alcohol consumption was ascertained by questionnaire, and BP was measured by in-home interviews and a mobile examination center.
BP was categorized according to the 2017 ACC/American Heart Association hypertension guideline, with elevated BP defined as systolic BP 120 mm Hg to 129 mm Hg and diastolic BP less than 80 mm Hg; stage 1 hypertension defined as systolic BP 130 mm Hg to 139 mm Hg or diastolic BP 80 mm Hg to 89 mm Hg; and stage 2 hypertension defined as systolic BP 140 mm Hg or higher or diastolic BP 90 mm Hg or higher.
Participants were stratified into four groups: former or never drinkers, light drinkers (1 to 6 drinks per week), moderate drinkers (7 to 13 per week) and heavy drinkers (14 or more per week).
Compared with never and former drinkers, those who reported moderate consumption had 19% higher odds of elevated BP (OR = 1.19; 95% CI, 0.93-1.52) and heavy drinkers had 44% higher odds of elevated BP (OR = 1.44; 95% CI, 1.13-1.84), Aladin said.
For stage 1 hypertension, moderate drinkers had 53% higher odds compared with never and former drinkers (OR = 1.53; 95% CI, 1.23-1.9), and heavy drinkers had 69% higher odds (OR = 1.69; 95% CI, 1.36-2.11).
Elevated risk for stage 2 hypertension was also observed among moderate drinkers (OR = 2.02; 95% CI, 1.52-2.69) and heavy drinkers (OR = 2.41; 95% CI, 1.83-3.16) compared with never and former drinkers.
Aladin said these data may help guide further research, public education and policy initiatives focused on the health consequences of moderate alcohol consumption.
“Our message from the study to our public and consumers is if you’re drinking a moderate or large amount of alcohol, please ask your provider to check your blood pressure each visit in order to help you cut down your drinking, and eventually to quit,” Aladin said.
The moderator of the briefing, Salim Virani, MD, PhD, FACC, chair of the ACC Council for the Prevention of Cardiovascular Disease and professor in the section of cardiovascular research at Baylor College of Medicine, said: “The guidelines would currently say that patients who are hypertensive should cut down on their alcohol intake, but this study shows that even moderate alcohol intake is associated with a higher odds of having hypertension. So, this is a very important public message in terms of how we talk to patients when they have hypertension, and at the same time, are drinking alcohol.” – by Earl Holland Jr.
Reference:
Aladin AI, et al. Abstract 1041-03. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.
Disclosures: Aladin and Virani report no relevant financial disclosures.
Perspective
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This is an observational study in the nationally representative cohort of U.S. adults that reaffirms the adverse impact of higher alcohol intake on BP using the 2017 ACC/AHA high BP guideline.
It showed that drinking alcohol 7 to 13 drinks a week carries 50% to 60% higher odds of stage 1 and stage 2 hypertension compared with normal and elevated BP.
I think this study will generate more interest in the mechanism of how alcohol may affect BP.
This research does not address the threshold of alcohol intake and BP in separately in men and women.
The AHA and many organizations have recommended no more than two drinks for men and one drink a day for women because of lower weight in women.
Whether this holds true in this analysis remains to be seen.
Many people drink alcohol on the weekends. It would be interesting to see if binge drinking on the weekend — 14 drinks all on Saturday or Sunday — compared to regular of drinking two drinks per day throughout the week will have the same impact on BP.
Director, Hypertension Section
Norman and Audrey Kaplan Chair in Hypertension
University of Texas Southwestern Medical Center
Associate Editor, Circulation
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