Alcohol and Hypertension-New Insights and Lingering Controversies

Overview

Journal Curr Hypertens Rep

Specialty Cardiology & Vascular Diseases

Date 2019 Sep 9

PMID 31494743

Citations 44

Authors

Ian B Puddey

Trevor A Mori

Anne E Barden

Lawrence J Beilin

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To examine outstanding issues in the relationship of alcohol to hypertension. These include whether the increase in BP with alcohol is causally related, the nature of the relationship in women, the contribution of alcohol-related increases in BP to cardiovascular disease and the aetiology of alcohol-related hypertension.

Recent Findings: Intervention studies and Mendelian randomisation analyses confirm the alcohol-BP relationship is causal. The concept that low-level alcohol intake reduces BP in women is increasingly unsustainable. Alcohol-related hypertension is in the causal pathway between alcohol use and increased risk for several cardiovascular outcomes. The aetiology of alcohol-related hypertension is multifactorial with recent data highlighting the effects of alcohol on the vasoconstrictor 20-HETE and oxidative stress. The high prevalence of both alcohol use and hypertension mandates a careful alcohol history in every patient with elevated BP. Early intervention for excessive alcohol use offers the promise of lower levels of BP and reduced risk of adverse cardiovascular outcomes.

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References

Perneger T, Whelton P, Puddey I, Klag M . Risk of end-stage renal disease associated with alcohol consumption. Am J Epidemiol. 1999; 150(12):1275-81. DOI: 10.1093/oxfordjournals.aje.a009958. View

Selenta C, Hogan B, Linden W . How often do office blood pressure measurements fail to identify true hypertension? An exploration of white-coat normotension. Arch Fam Med. 2000; 9(6):533-40. DOI: 10.1001/archfami.9.6.533. View

Xin X, He J, Frontini M, Ogden L, Motsamai O, Whelton P . Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2001; 38(5):1112-7. DOI: 10.1161/hy1101.093424. View

Henriksson K, Lindblad U, Gullberg B, Agren B, Nilsson-Ehle P, Rastam L . Development of hypertension over 6 years in a birth cohort of young middle-aged men: the Cardiovascular Risk Factor Study in southern Sweden (CRISS). J Intern Med. 2002; 252(1):21-6. DOI: 10.1046/j.1365-2796.2002.00996.x. View

Zilkens R, Rich L, Burke V, Beilin L, Watts G, Puddey I . Effects of alcohol intake on endothelial function in men: a randomized controlled trial. J Hypertens. 2003; 21(1):97-103. DOI: 10.1097/00004872-200301000-00019. View

Ward N, Puddey I, Hodgson J, Beilin L, Croft K . Urinary 20-hydroxyeicosatetraenoic acid excretion is associated with oxidative stress in hypertensive subjects. Free Radic Biol Med. 2005; 38(8):1032-6. DOI: 10.1016/j.freeradbiomed.2004.12.024. View

Collins X, Harmon S, Kaduce T, Berst K, Fang X, Moore S . Omega-oxidation of 20-hydroxyeicosatetraenoic acid (20-HETE) in cerebral microvascular smooth muscle and endothelium by alcohol dehydrogenase 4. J Biol Chem. 2005; 280(39):33157-64. DOI: 10.1074/jbc.M504055200. View

Barden A, Zilkens R, Croft K, Mori T, Burke V, Beilin L . A reduction in alcohol consumption is associated with reduced plasma F2-isoprostanes and urinary 20-HETE excretion in men. Free Radic Biol Med. 2007; 42(11):1730-5. DOI: 10.1016/j.freeradbiomed.2007.03.004. View

Hui P, Nakayama T, Morita A, Sato N, Hishiki M, Saito K . Common single nucleotide polymorphisms in Japanese patients with essential hypertension: aldehyde dehydrogenase 2 gene as a risk factor independent of alcohol consumption. Hypertens Res. 2007; 30(7):585-92. DOI: 10.1291/hypres.30.585. View

10.

Ishizuka T, Cheng J, Singh H, Vitto M, Manthati V, Falck J . 20-Hydroxyeicosatetraenoic acid stimulates nuclear factor-kappaB activation and the production of inflammatory cytokines in human endothelial cells. J Pharmacol Exp Ther. 2007; 324(1):103-10. DOI: 10.1124/jpet.107.130336. View

11.

Chen L, Davey Smith G, Harbord R, Lewis S . Alcohol intake and blood pressure: a systematic review implementing a Mendelian randomization approach. PLoS Med. 2008; 5(3):e52. PMC: 2265305. DOI: 10.1371/journal.pmed.0050052. View

12.

Neutel J, Schumacher H, Gosse P, Lacourciere Y, Williams B . Magnitude of the early morning blood pressure surge in untreated hypertensive patients: a pooled analysis. Int J Clin Pract. 2008; 62(11):1654-63. DOI: 10.1111/j.1742-1241.2008.01892.x. View

13.

Ishikawa Y, Ishikawa J, Ishikawa S, Kayaba K, Nakamura Y, Shimada K . Prevalence and determinants of prehypertension in a Japanese general population: the Jichi Medical School Cohort Study. Hypertens Res. 2008; 31(7):1323-30. DOI: 10.1291/hypres.31.1323. View

14.

Ohira T, Tanigawa T, Tabata M, Imano H, Kitamura A, Kiyama M . Effects of habitual alcohol intake on ambulatory blood pressure, heart rate, and its variability among Japanese men. Hypertension. 2008; 53(1):13-9. DOI: 10.1161/HYPERTENSIONAHA.108.114835. View

15.

Bryson C, Au D, Sun H, Williams E, Kivlahan D, Bradley K . Alcohol screening scores and medication nonadherence. Ann Intern Med. 2008; 149(11):795-804. DOI: 10.7326/0003-4819-149-11-200812020-00004. View

16.

Greenlund K, Daviglus M, Croft J . Differences in healthy lifestyle characteristics between adults with prehypertension and normal blood pressure. J Hypertens. 2009; 27(5):955-62. DOI: 10.1097/HJH.0b013e32832926fb. View

17.

White S, Polkinghorne K, Cass A, Shaw J, Atkins R, Chadban S . Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study. Nephrol Dial Transplant. 2009; 24(8):2464-72. DOI: 10.1093/ndt/gfp114. View

18.

Trudel X, Brisson C, Larocque B, Milot A . Masked hypertension: different blood pressure measurement methodology and risk factors in a working population. J Hypertens. 2009; 27(8):1560-7. DOI: 10.1097/HJH.0b013e32832cb036. View

19.

Schutze M, Schulz M, Steffen A, Bergmann M, Kroke A, Lissner L . Beer consumption and the 'beer belly': scientific basis or common belief?. Eur J Clin Nutr. 2009; 63(9):1143-9. DOI: 10.1038/ejcn.2009.39. View

20.

Taylor B, Irving H, Baliunas D, Roerecke M, Patra J, Mohapatra S . Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. Addiction. 2009; 104(12):1981-90. DOI: 10.1111/j.1360-0443.2009.02694.x. View