Hypertension and chronic ethanol consumption: What do we know after a century of study?

Abstract

The influences of life habits on the cardiovascular system may have important implications for public health, as cardiovascular diseases are among the leading causes of shorter life expectancy worldwide. A link between excessive ethyl alcohol (ethanol) consumption and arterial hypertension was first suggested early last century. Since then, this proposition has received considerable attention. Support for the concept of ethanol as a cause of hypertension derives from several epidemiologic studies demonstrating that in the general population, increased blood pressure is significantly correlated with ethanol consumption. Although the link between ethanol consumption and hypertension is well established, the mechanism through which ethanol increases blood pressure remains elusive. Possible mechanisms underlying ethanol-induced hypertension were proposed based on clinical and experimental observations. These mechanisms include an increase in sympathetic nervous system activity, stimulation of the renin-angiotensin-aldosterone system, an increase of intracellular Ca²⁺ in vascular smooth muscle, increased oxidative stress and endothelial dysfunction. The present report reviews the relationship between ethanol intake and hypertension and highlights some mechanisms underlying this response. These issues are of interest for the public health, as ethanol consumption contributes to blood pressure elevation in the population.

Keywords: Ethanol; Hypertension; Calcium; Nitric oxide; Oxidative stress

Core tip: After a century of study, the relationship between chronic ethanol consumption and hypertension is well established. This review provides a description of the main studies that showed a relationship between chronic ethanol consumption and hypertension in humans. We also discuss studies using animal models of ethanol-induced hypertension, describing the main mechanisms by which ethanol consumption leads to hypertension.