|
1
|
The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults. Br J Nutr 2021; 126:1380-1388. [PMID: 33441197 DOI: 10.1017/s0007114521000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Given the dynamic characteristic of an individual's drinking behaviours, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥ 40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5·3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the third visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2·9 mmHg, P = 0·032) and -adjusted models (3·6 mmHg, P = 0·001), and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3·9 mmHg, P = 0·003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption rather than the trajectory may be significantly related to raised SBP, and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP is adjusted in men.
Collapse
|
|
2
|
Coelho JS, Martinez OGE, Siqueira JH, Campos GC, Viana MC, Griep RH, Alvim RO, Mill JG, Molina MCB. Alcoholic beverage consumption, changes in blood pressure, and incidence of hypertension in the Longitudinal Adult Health Study (ELSA-Brasil). Nutrition 2021; 91-92:111387. [PMID: 34303960 DOI: 10.1016/j.nut.2021.111387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 05/11/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Alcohol consumption is generally associated with increased risk of hypertension. We aimed to investigate, prospectively, the effect of alcoholic-beverage consumption on blood pressure (BP) and incidence of hypertension, after a 4-y follow-up, in participants of the Longitudinal Adult Health Study (ELSA-Brasil). METHODS We analyzed information from 3,990 participants (ages 35-74 y), men and women, from educational and research institutions, at baseline (2008-2010) and follow-up (2012-2014). Socioeconomic, hemodynamic, anthropometric, and health data were collected. Hypertension was defined as systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg and/or use of antihypertensive medication. Change in alcohol consumption (g/d) was estimated by subtracting total consumed at follow-up from total consumed at baseline, and was categorized in tertiles. RESULTS The consumption of alcoholic beverages was associated with changes in BP and hypertension only in men. Individuals who reduced total consumption of alcohol showed a smaller increase in systolic BP (1.1 versus 2.3 mm Hg; P = 0.03) and diastolic BP (1.3 versus 2.2 mm Hg; P = 0.008) compared to individuals who increased consumption. In addition, individuals in the highest tertiles of total consumption of alcohol (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.14-2.29) and consumption of beer (OR, 1.51; 95% CI, 1.07-12.13), wine (OR, 1.71; 95% CI, 1.01-2.86), and spirits (OR, 2.01; 95% CI, 1.21-3.32) showed higher odds ratios for hypertension compared to the lowest tertile. CONCLUSIONS Increased consumption of alcoholic beverages was positively associated with increased BP levels and higher chances of developing hypertension in men.
Collapse
Affiliation(s)
- Juliana S Coelho
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Oscar G E Martinez
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Jordana H Siqueira
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Gláucia C Campos
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Maria C Viana
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Rosane H Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rafael O Alvim
- Department of Physiological Sciences, Federal University of Amazonas, Manaus, Brazil
| | - José G Mill
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Maria C B Molina
- Post Graduate Program in Public Health, Federal University of Espírito Santo, Espírito Santo, Brazil.
| |
Collapse
|
|
3
|
Abstract
The consumption of ethanol can have both beneficial and detrimental effects on the function of the heart and cardiovascular system, depending on the amount consumed. Low-to-moderate amounts of ethanol intake are associated with improvements in cardiac function and vascular health. On the other hand, ethanol chronically consumed in large amounts acts as a toxin to the heart and vasculature. The cardiac injury produced by chronic alcohol abuse can progress to heart failure and eventual death. Furthermore, alcohol abuse may exacerbate preexisting heart conditions, such as hypertension and cardiomyopathy. This article focuses on the molecular mechanisms and pathophysiology of both the beneficial and detrimental cardiac effects of alcohol.
Collapse
Affiliation(s)
- Jason D Gardner
- Department of Physiology, Alcohol and Drugs of Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | | |
Collapse
|
|
4
|
Collart F, de Timary P, Dom G, Dor BD, Duprez D, Lengelé JP, Matthys F, Peuskens H, Rehm J, Stärkel P. Alcohol-induced hypertension: an important healthcare target in Belgium. Acta Clin Belg 2015; 70:389-95. [PMID: 26135944 DOI: 10.1179/2295333715y.0000000039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Excessive alcohol intake is one of the leading causes of premature death in Europe and particularly in Belgium. Belgian people are consuming more alcohol per year than the European average. It is well established that excessive alcohol consumption is a significant predictor of the development of hypertension (HTN). Two million adults in Belgium suffer from HTN and this number will increase to three million by 2025. Less than 50% of Belgian people treated for HTN are well-controlled. Alcohol reduction in patients with HTN can significantly lower systolic and diastolic blood pressure. After reviewing the epidemiology of HTN and alcohol disorders in Belgium, this paper will focus on the rationale for alcohol screening and brief intervention in primary care. It will also describe the barriers to alcohol screening, and what could be the benefits of alcohol screening for our healthcare system. The authors believe that early identification through alcohol screening and brief intervention in general practice can help to improve the management of patients with HTN, to reach the targets of the WHO Global Action Plan, i.e., a 25% relative reduction in the risk of premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases. They are also convinced that this would allow achieving major healthcare savings.
Collapse
Affiliation(s)
- F Collart
- 1 Department of Nephrology, CHU/UVC Brugmann , Brussels, Belgium
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
5
|
Iriti M, Varoni EM. Cardioprotective effects of moderate red wine consumption: Polyphenols vs. ethanol. J Appl Biomed 2014. [DOI: 10.1016/j.jab.2014.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
|
6
|
Long-term alcohol consumption is an independent risk factor of hypertension development in northern China: evidence from Kailuan study. J Hypertens 2014; 31:2342-7. [PMID: 24029874 DOI: 10.1097/hjh.0b013e3283653999] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The purpose of the present study was to determine the impact of alcohol consumption on the incidence of hypertension. METHODS A total of 32,389 male coal mine workers from Kailuan Coal Group in northern China (Kailuan study), free of hypertension, myocardial infarction, stroke, transient ischemia attack and cancer, were followed up every 2 years for 4 years. The average alcohol intake during the past year was reported as baseline. RESULTS During 4 years of follow-up, 9151 out of 32,389 workers developed hypertension categorically. At the end of the follow-up, the cumulative incidence of hypertension in relation to daily alcoholic intake of none, 1-24, 25-49, 50-99, 100-149 and at least 150 g was 25.03, 28.82, 30.10, 37.07, 40.14 and 42.49%, respectively. After adjusting for age, we found that the relative risk of hypertension in those who were never exposed to alcohol was the lowest, with the group 25-49 g/day being the next. This trend was unchanged after adjustment for age, exercise, smoking status, job type and salt intake. After further adjustment for BMI, history of high cholesterol and diabetes mellitus, a positive, linear association between alcohol consumption and the risk of hypertension was found. Models stratified by baseline SBP (<120 and 120-139 mmHg) or DBP (<80 and 80-89 mmHg) did not alter the trend. CONCLUSION The Kailuan study demonstrates that long-term alcohol intake is an independent risk factor of incident hypertension in a large cohort of coal mine workers. Even light-to-moderate alcohol consumption increases the risk of incident hypertension.
Collapse
|
|
7
|
Husain K, Ansari RA, Ferder L. Alcohol-induced hypertension: Mechanism and prevention. World J Cardiol 2014; 6:245-252. [PMID: 24891935 PMCID: PMC4038773 DOI: 10.4330/wjc.v6.i5.245] [Citation(s) in RCA: 191] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
Epidemiological, preclinical and clinical studies established the association between high alcohol consumption and hypertension. However the mechanism through which alcohol raises blood pressure remains elusive. Several possible mechanisms have been proposed such as an imbalance of the central nervous system, impairment of the baroreceptors, enhanced sympathetic activity, stimulation of the renin-angiotensin-aldosterone system, increased cortisol levels, increased vascular reactivity due to increase in intracellular calcium levels, stimulation of the endothelium to release vasoconstrictors and loss of relaxation due to inflammation and oxidative injury of the endothelium leading to inhibition of endothelium-dependent nitric oxide production. Loss of relaxation due to inflammation and oxidative injury of the endothelium by angiotensin II leading to inhibition of endothelium-dependent nitric oxide production is the major contributors of the alcohol-induced hypertension. For the prevention of alcohol-induced hypertension is to reduce the amount of alcohol intake. Physical conditioning/exercise training is one of the most important strategies to prevent/treat chronic alcohol-induced hypertension on physiological basis. The efficacious pharmacologic treatment includes the angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARBs) which have antioxidant activity and calcium channel blockers. The most effective prevention and treatment of alcohol-induced hypertension is physical exercise and the use of ACE inhibitors or ARBs in the clinic
Collapse
|
|
8
|
Chiva-Blanch G, Arranz S, Lamuela-Raventos RM, Estruch R. Effects of wine, alcohol and polyphenols on cardiovascular disease risk factors: evidences from human studies. Alcohol Alcohol 2013; 48:270-7. [PMID: 23408240 DOI: 10.1093/alcalc/agt007] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIMS The aim of this review was to focus on the knowledge of the cardiovascular benefits of moderate alcohol consumption, as well as to analyze the effects of the different types of alcoholic beverages. METHODS Systematic revision of human clinical studies and meta-analyses related to moderate alcohol consumption and cardiovascular disease (CVD) from 2000 to 2012. RESULTS Heavy or binge alcohol consumption unquestionably leads to increased morbidity and mortality. Nevertheless, moderate alcohol consumption, especially alcoholic beverages rich in polyphenols, such as wine and beer, seems to confer cardiovascular protective effects in patients with documented CVD and even in healthy subjects. CONCLUSIONS In conclusion, wine and beer (but especially red wine) seem to confer greater cardiovascular protection than spirits because of their polyphenolic content. However, caution should be taken when making recommendations related to alcohol consumption.
Collapse
Affiliation(s)
- Gemma Chiva-Blanch
- Department of Internal Medicine, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
| | | | | | | |
Collapse
|
|
9
|
Chiva-Blanch G, Urpi-Sarda M, Ros E, Arranz S, Valderas-Martínez P, Casas R, Sacanella E, Llorach R, Lamuela-Raventos RM, Andres-Lacueva C, Estruch R. Dealcoholized red wine decreases systolic and diastolic blood pressure and increases plasma nitric oxide: short communication. Circ Res 2012; 111:1065-8. [PMID: 22955728 DOI: 10.1161/circresaha.112.275636] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
RATIONALE Experimental studies have shown a potential blood pressure (BP) lowering effect of red wine polyphenols, whereas the effects of ethanol and polyphenols on BP in humans are not yet clear. OBJECTIVE The aim of the present work was to evaluate the effects of red wine fractions (alcoholic and nonalcoholic) on BP and plasma nitric oxide (NO) in subjects at high cardiovascular risk. METHODS AND RESULTS Sixty-seven men at high cardiovascular risk were studied. After a 2-week run-in period, subjects were randomized into 3 treatment periods in a crossover clinical trial, with a common background diet plus red wine (30g alcohol/day), the equivalent amount of dealcoholized red wine, or gin (30g alcohol/day), lasting 4 weeks each intervention. At baseline and after each intervention, anthropometrical parameters, BP and plasma NO were measured. Systolic and diastolic BP decreased significantly after the dealcoholized red wine intervention and these changes correlated with increases in plasma NO. CONCLUSIONS Dealcoholized red wine decreases systolic and diastolic BP. Our results point out through an NO-mediated mechanism. The daily consumption of dealcoholized red wine could be useful for the prevention of low to moderate hypertension. Trial registered at controlled-trials.com: ISRCTN88720134.
Collapse
Affiliation(s)
- Gemma Chiva-Blanch
- Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
10
|
Andersen UO, Jensen GB. Population blood pressure and low to moderate alcohol intake in an untreated population followed over 20years. Copenhagen City heart study. Eur J Intern Med 2011; 22:514-7. [PMID: 21925063 DOI: 10.1016/j.ejim.2011.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 01/02/2011] [Accepted: 01/14/2011] [Indexed: 11/29/2022]
Abstract
UNLABELLED The aim of this study is to evaluate whether a changing population alcohol intake is capable of setting off a shift in the blood pressure distribution in the untreated part of a population. The focus is on subjects with an alcohol intake well below the limits of alcoholism because these subjects make out the majority of the population. The Copenhagen City Heart Study is a prospective longitudinal epidemiological study. The untreated study population was followed over 20years. Specially trained technicians using a blinded sphygmomanometer measured BP once with the subject in the sitting position. The BP measurement was fully standardised and the measurement method was unchanged throughout the observation period. A questionnaire concerning drinking habits was completed by the participants and double-checked by the technicians. The results were a decreasing population systolic BP and an increasing self-reported alcohol intake. The population increase was based on an increasing proportion of light to moderate drinkers. There was no effect of a moderately increasing alcohol intake as a covariate in a multivariate analysis of population systolic BP. CONCLUSION A moderately increasing population alcohol intake cannot explain the observed changes in population systolic blood pressure.
Collapse
Affiliation(s)
- Ulla Overgaard Andersen
- Copenhagen City Heart Study, Epidemiological Research Unit, Copenhagen University Hospital, Bispebjerg, DK 2400 Copenhagen NV, Denmark.
| | | |
Collapse
|
|
11
|
Alcohol does not modulate the augmented acetylcholine-induced vasodilatory response in hemorrhaged rodents. Shock 2010; 32:601-7. [PMID: 19197228 DOI: 10.1097/shk.0b013e31819e2b9a] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Our previous studies have shown that acute alcohol intoxication (AAI) decreases blood pressure, exacerbates hypotension after hemorrhagic shock, impairs the pressor response to fluid resuscitation, and blunts neuroendocrine activation. We hypothesized that impaired hemodynamic compensation during and after hemorrhagic shock in the acute alcohol-intoxicated host is the result of blunted neuroendocrine activation or, alternatively, of an impaired vascular responsiveness to vasoactive agents. The aim of this study was to examine the effects of AAI, AAI and hemorrhagic shock, and AAI and hemorrhagic shock and resuscitation on reactivity of isolated blood vessel rings to phenylephrine and acetylcholine. Chronically instrumented, conscious male Sprague-Dawley rats (300-350 g) received a primed continuous 15-h intragastric alcohol infusion (2.5 g x kg(-1) + 300 mg x kg(-1) x h(-1)), and time-matched controls received an isocaloric-isovolumic dextrose infusion. At completion of infusions, animals were randomized to sham, 60-min fixed-pressure hemorrhage, or hemorrhagic shock followed by resuscitation with lactated Ringer's solution. At the completion of the experimental protocols, animals were killed, and thoracic aorta and mesenteric artery ring segments (1-2 mm) were prepared and studied in myograph baths. Acute alcohol intoxication did not produce significant alterations in either pressor or dilator responses in aortic or mesenteric rings. These findings suggest that impaired hemodynamic counterregulation during hemorrhagic shock in AAI is not due to decreased vasopressor responsiveness. However, our results suggest a role for accentuated vasodilatory responses that may be central in progression to decompensatory shock.
Collapse
|
|
12
|
Abstract
Therapeutic lifestyle changes (TLC) are important for the prevention and management of, as well as adjuncts to, pharmacotherapy of hypertension. This article reviews relevant TLC and their effects on blood pressure (BP) levels, with emphasis on exercise and dietary habits. Regular, moderate-intensity (40%-70% of heart rate reserve) aerobic exercise training for 30 to 60 minutes, 3 to 5 times per week, can lower systolic and diastolic BP levels, with a greater reduction observed in patients with hypertension compared with those with normal BP levels. A diet rich in fruits, vegetables, and whole grains, with a moderate intake of fat-free or low-fat dairy products, and low in saturated and total fat, sodium, and alcohol, such as the Dietary Approaches to Stop Hypertension eating pattern, also significantly reduces BP levels. A TLC program including regular exercise and dietary modifications along with weight management appears to result in a greater BP reduction than either intervention alone. TLC can also significantly reduce other risk factors for cardiovascular disease commonly accompanying hypertension. Multiple mechanisms appear to contribute to BP reduction by dietary intervention (reduced weight, sodium, and alcohol and increased calcium, potassium, and magnesium). For exercise, these include improvements in arterial endothelial function and compliance, left ventricular structure and function, and perhaps vascular blood supply with increased cardiorespiratory endurance. The available evidence is robust in support of TLC for management of elevated BP and for the primary prevention of hypertension, supporting the recommendations by the Joint National Committee Seventh Report on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
Collapse
Affiliation(s)
- Ulf G. Bronas
- School of Nursing, University of Minnesota, Minneapolis,
| | - Arthur S. Leon
- Laboratory of Physiological Hygiene and Exercise Science, School of Kinesiology, University of Minnesota, Minneapolis
| |
Collapse
|
|
13
|
Alcohol sensitivity, alcohol use and hypertension in an older Chinese population: the Guangzhou Biobank Cohort Study. Hypertens Res 2009; 32:741-7. [DOI: 10.1038/hr.2009.92] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
|
14
|
Momose Y, Une H, Hayashi M, Takeyama N. Prevalence and Risk Factors of Hypertension without Controlled Drug Treatment in Three Regions: A Study of Japanese Rural Populations. J Rural Med 2009. [DOI: 10.2185/jrm.4.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
|
15
|
Suwazono Y, Sakata K, Oishi M, Okubo Y, Dochi M, Kobayashi E, Kido T, Nogawa K. Estimation of benchmark dose as the threshold amount of alcohol consumption for blood pressure in Japanese workers. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2007; 27:1487-1495. [PMID: 18093048 DOI: 10.1111/j.1539-6924.2007.00983.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In order to determine the threshold amount of alcohol consumption for blood pressure, we calculated the benchmark dose (BMD) of alcohol consumption and its 95% lower confidence interval (BMDL) in Japanese workers. The subjects consisted of 4,383 males and 387 females in a Japanese steel company. The target variables were systolic, diastolic, and mean arterial pressures. The effects of other potential covariates such as age and body mass index were adjusted by including these covariates in the multiple linear regression models. In male workers, BMD/BMDL for alcohol consumption (g/week) at which the probability of an adverse response was estimated to increase by 5% relative to no alcohol consumption, were 396/315 (systolic blood pressure), 321/265 (diastolic blood pressure), and 326/269 (mean arterial pressures). These values were based on significant regression coefficients of alcohol consumption. In female workers, BMD/BMDL for alcohol consumption based on insignificant regression coefficients were 693/134 (systolic blood pressure), 199/90 (diastolic blood pressure), and 267/77 (mean arterial pressure). Therefore, BMDs/BMDLs in males were more informative than those in females as there was no significant relationship between alcohol and blood pressure in females. The threshold amount of alcohol consumption determined in this study provides valuable information for preventing alcohol-induced hypertension.
Collapse
Affiliation(s)
- Yasushi Suwazono
- Department of Occupational and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
|
16
|
McFarlane SI, von Gizycki H, Salifu M, Deshmukh M, Manieram M, Gebreegziabher Y, Gliwa AA, Bordia S, Shah S, Sowers JR. Alcohol consumption and blood pressure in the adult US population: assessment of gender-related effects. J Hypertens 2007; 25:965-70. [PMID: 17414659 DOI: 10.1097/hjh.0b013e32807fb0ad] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Our objective was to assess the gender-related effects of alcohol consumption on blood pressure (BP) in a representative sample of the adult US population. METHODS We examined data from the National Health and Nutrition Examination Survey 1999-2000. The effects of various risk factors for hypertension on BP were examined with analysis of covariance statistics. RESULTS Of the 5448 adults over 20 years of age, 2650 (48.7%) reported the intake of one or more drinks per day over the past year. In this population, the mean +/- SEM age was 46.9 +/- 0.34 years, the body mass index was 24.8 kg/m, 1257 (47.4%) were women, systolic BP was 124.3 +/- 0.44 mmHg and diastolic BP was 72.7 +/- 0.27 mmHg. Hypertension was reported in 21.1%, diabetes in 5.1% and cigarette smoking in 39.7%. A significant effect on systolic BP was shown with age (P < 0.01), body mass index (P < 0.01), race (P = 0.01), gender (P < 0.01) and diabetes (P < 0.01). The interaction with gender and alcohol drinking level was significant (P = 0.02). Post-hoc analysis localized the source of this effect. There was a significant increase in systolic BP between one and three and between one and four, but not between one and two, drinks per day in men. This effect was not observed in women. CONCLUSION Consistent with previous reports, our study suggests that alcohol intake up to two drinks per day has no effect on BP. There was a gender-related effect of alcohol intake in excess of two drinks per day on BP, with increased BP observed only in men but not in women.
Collapse
Affiliation(s)
- Samy I McFarlane
- Division of Endocrinology/Biostatistics, SUNY-Downstate Medical Center/Kings County Hospital, Brooklyn, New York 11203, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
|
17
|
Vasdev S, Gill V, Singal PK. Beneficial effect of low ethanol intake on the cardiovascular system: possible biochemical mechanisms. Vasc Health Risk Manag 2007; 2:263-76. [PMID: 17326332 PMCID: PMC1993980 DOI: 10.2147/vhrm.2006.2.3.263] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Low ethanol intake is known to have a beneficial effect on cardiovascular disease. In cardiovascular disease, insulin resistance leads to altered glucose and lipid metabolism resulting in an increased production of aldehydes, including methylglyoxal. Aldehydes react non-enzymatically with sulfhydryl and amino groups of proteins forming advanced glycation end products (AGEs), altering protein structure and function. These alterations cause endothelial dysfunction with increased cytosolic free calcium, peripheral vascular resistance, and blood pressure. AGEs produce atherogenic effects including oxidative stress, platelet adhesion, inflammation, smooth muscle cell proliferation and modification of lipoproteins. Low ethanol intake attenuates hypertension and atherosclerosis but the mechanism of this effect is not clear. Ethanol at low concentrations is metabolized by low Km alcohol dehydrogenase and aldehyde dehydrogenase, both reactions resulting in the production of reduced nicotinamide adenine dinucleotide (NADH). This creates a reductive environment, decreasing oxidative stress and secondary production of aldehydes through lipid peroxidation. NADH may also increase the tissue levels of the antioxidants cysteine and glutathione, which bind aldehydes and stimulate methylglyoxal catabolism. Low ethanol improves insulin resistance, increases high-density lipoprotein and stimulates activity of the antioxidant enzyme, paraoxonase. In conclusion, we suggest that chronic low ethanol intake confers its beneficial effect mainly through its ability to increase antioxidant capacity and lower AGEs.
Collapse
Affiliation(s)
- Sudesh Vasdev
- Discipline of Medicine, Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, St.John's, Newfoundland, Canada.
| | | | | |
Collapse
|
|
18
|
Puddey IB, Beilin LJ. Alcohol and Hypertension. Hypertension 2005. [DOI: 10.1016/b978-0-7216-0258-5.50135-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
|
19
|
Vernay M, Balkau B, Moreau JG, Sigalas J, Chesnier MC, Ducimetiere P. Alcohol consumption and insulin resistance syndrome parameters: associations and evolutions in a longitudinal analysis of the French DESIR cohort. Ann Epidemiol 2004; 14:209-14. [PMID: 15036225 DOI: 10.1016/s1047-2797(03)00131-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2002] [Accepted: 05/06/2003] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine the effects of average alcohol consumption and changes in alcohol intake on the insulin resistance syndrome parameters in a 3-year follow-up study. METHODS Longitudinal study of 1856 and 1529 alcohol drinking men and women in the French DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome), aged 30 to 64 years. RESULTS In men, fasting glucose, body mass index, waist circumference, systolic blood pressure, and HDL-cholesterol were positively associated with average alcohol consumption while there was no association with insulin or triglycerides concentrations. A change in alcohol intake was positively associated with HDL-cholesterol concentration and systolic blood pressure at follow-up. These effects of alcohol could not be attributed specifically to the intake of wine. In women, while the alcohol HDL-cholesterol relation was similar to that found in the men, the only significant effect of average alcohol intake was an increase in systolic blood pressure, with a spurious decrease in blood pressure related to a 3-year increase in alcohol intake. CONCLUSIONS Alcohol only provided a beneficial effect on HDL-cholesterol. The beneficial effect seen by other authors of moderate alcohol drinking on diabetes and cardiovascular risk may be due to effects on parameters other than those included in the current definitions of the insulin resistance syndrome.
Collapse
Affiliation(s)
- Michel Vernay
- INSERM U258-IFR69, Université Paris XI, Villejuif, France
| | | | | | | | | | | |
Collapse
|
|
20
|
Okubo Y, Suwazono Y, Kobayashi E, Nogawa K. An association between smoking habits and blood pressure in normotensive Japanese men: a 5-year follow-up study. Drug Alcohol Depend 2004; 73:167-74. [PMID: 14725956 DOI: 10.1016/j.drugalcdep.2003.10.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND There are few studies on the effects of smoking on blood pressure (BP) that consider confounding factors such as age, obesity, lifestyle and blood chemistry. As such, we conducted a 5-year follow-up study to clarify the effects of smoking habits on blood pressure in normotensive Japanese men. METHODS The subjects were 2107 normotensive male steelworkers aged 40-54 years. They were classified using three indices: smoking habits in 1990, changes in smoking habits, and changes in amount of smoking. The associations between these indices and changes in blood pressure were evaluated using analysis of covariance (ANCOVA). As analyses, BMI, salt intake, physical activity, drinking habit, and results of blood chemistry in 1990 and their changes, age and blood pressure in 1990 were used as covariates. RESULTS The cumulative incidence of hypertension in smokers was lower than in non- and ex-smokers. The adjusted mean of change in blood pressure of smokers was significantly lower than in non- and ex-smokers. No significant difference between non-smokers and ex-smokers, or among groups of smokers who varied their amount of smoking was observed. CONCLUSION Chronic smoking reduces changes in blood pressure and 5-year cumulative incidence of hypertension. However, no significant dose-dependent effect of smoking on changes in blood pressure was observed.
Collapse
Affiliation(s)
- Yasushi Okubo
- Department of Occupational and Environmental Medicine (A2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | | | | | | |
Collapse
|
|
21
|
Abstract
Various disorders and risk factors prevent wound healing in patients with peripheral vascular disease. These mostly can be treated with non-pharmacological interventions, such as smoking cessation and diabetes management.
Collapse
Affiliation(s)
- M D Kerstein
- Department of Surgery, Mount Sinai Medical Center, New York, USA
| | | |
Collapse
|