Analysis suggests causal link between daily alcohol consumption and high blood pressure
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Key takeaways:
- Alcohol intake of more than 12 g per day was associated with increased risk for hypertension.
- Hypertension risk plateaued at higher levels of alcohol intake for men, but risk continued to rise for women.
The association between daily alcohol consumption and risk for hypertension is a linear relationship and the strength of the association varied between men and women, researchers reported.
“Alcohol consumption has been associated with a variety of cardiovascular disease outcomes, including cardiomyopathies, coronary artery disease, stroke, and increased BP, the latter end point of BP having been recently reviewed through a dose-response meta-analysis. However, uncertainties exist regarding its association with the risk of hard outcomes including hypertension, particularly at low levels of alcohol intake and whether sex and race modify the association,” Marta Cecchini, a PhD student at Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), section of public health in the department of biomedical, metabolic and neural sciences at University of Modena and Reggio Emilia, Italy, and colleagues wrote. “We took advantage of a new statistical technique that allows pooling and flexible modeling of the dose-response relationship between exposures and endpoints to assess the overall association between chronic alcohol intake and risk of hypertension in nonexperimental longitudinal studies.”
For their meta-analysis, published in Hypertension, Cecchini and colleagues included 23 studies from the U.S., U.K., Japan, China, South Korea, Spain and eastern Finland published between 1990 and 2023. The analysis included 600,000 participants and 45,000 cases of incident hypertension during 2 to 22 years of follow-up.
Across the included analyses, alcohol intake was assessed using simple or standardized questionnaires or interview-based questionnaires or interviews by trained health professionals.
Compared with a daily intake of 12 g per day, risk for hypertension increased with higher daily alcohol intake in a linear fashion:
- 0 g per day (RR = 0.89; 95% CI, 0.84-0.94);
- 24 g per day (RR = 1.11; 95% CI, 1.07-1.15);
- 36 g per day (RR = 1.22; 95% CI, 1.14-1.3); and
- 48 g per day (RR = 1.33; 95% CI, 1.18-1.49).
Results of a sex-stratified analysis indicated that men experienced increased risk for hypertension with increased alcohol intake, but the risk plateaued at levels above 12 g per day with RRs between 1.12 and 1.27. For women, hypertension risk continued to rise as daily alcohol intake increased, with an RR of 1.14 at 24 g per day, to 1.69 at 48 g per day.
“This suggests that sex acts as an effect modifier for the association between alcohol intake and risk of hypertension, and that low levels of alcohol consumption may not increase the risk of hypertension in women, while at higher levels of alcohol intake the risk of hypertension appears to be higher than in men,” the researchers wrote. “Therefore, based on our analysis, a moderate to high usual intake of alcohol seems to be a risk factor for hypertension in both men and women, with a steeper slope in women. In contrast, at low levels of alcohol intake, an increased risk of hypertension may only apply in men.”
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