Blood Pressure Dysregulation Associated with Alcohol Withdrawal

Alcoholics' blood pressures (BP) are typically elevated during withdrawal. Do such elevations predict future blood pressure dysregulation or are they simply a transitory effect of alcohol toxicity? Thirty-two patients admitted to the hospital for alcohol detoxification were tested to examine the relationship between admission BP and response to isometric handgrip administered 4 to 5 days (session 1) and 3 to 4 weeks (session 2) postdetoxification. Alcoholics were divided into three groups based on admission BPs: Hypertensive (HT, greater than or equal to 160/95 mmHg), Borderline Hypertensive (BHT, 140/90-159/94 mmHg), and Normotensive (NT, less than 140/90 mmHg). In sessions 1 and 2, the groups no longer differed on resting BP or heart rate (HR) but did differ on BP and HR response to handgrip: Compared with the NT group, the HT and BHT groups had greater rises in systolic and diastolic BP and HR. There was a trend for HT alcoholics to report a positive parental history of hypertension (91%) compared to BHT and NT alcoholics (64% and 60%, respectively), suggesting the existence of premorbid factors to this exaggerated cardiovascular response. Further, alcohol consumption, based on a quantity-frequency index, was significantly higher in the HT group than in the NT group. The results suggest that transitory elevations in blood pressure observed during alcohol withdrawal may predict future BP abnormalities.