Under the influence? Drinking alcohol may raise your risk of systemic hypertension

Consuming alcohol—even just one or two drinks per dayis associated with an elevated risk of stage 1 and stage 2 systemic hypertension (SH), according to new data published in the American Journal of Cardiology.

Researchers set out to examine the link between alcohol consumption and blood pressure (BP) categories based on the 2017 American College of Cardiology/American Heart Association High Blood Pressure guidelines, analyzing data from the Third National Health and Nutrition Examination Survey (NHANES).

The group studied 17,059 participants overall, and 53% were women. The mean patient age was 46 years old. 

Participants were asked questions regarding their alcohol consumption. In addition, their blood pressure was measured during an interview at their home and a visit to a mobile examination center.

Compared with those who never drank, moderate drinkers (7 to 13 drinks per week) were at an increased risk for stage 1 and stage 2 SH.

On the other hand, patients who drank heavily (more than 14 drinks per week) were more likely to have elevated systolic and diastolic BPs, higher high-density lipoprotein levels and lower levels of physical activity. They also faced an even higher risk of stage 1 or 2 SH. 

These patients were mostly young, men, non-whites and current smokers. 

“An important finding of our study was that age was an effect modifier of the association between alcohol and SH," wrote lead author Amer I. Aladin, MD,MS, with the section of interventional cardiology, MedStar Georgetown University/Washington Hospital Center, and colleagues. “In an age-stratified analysis, we found that among those who consumed 7 to 13 drinks/week and ≥14 drinks/week, age <65 years was significantly associated with higher odds of having stage 1 and stage 2 SH. There was no association between alcohol consumption and SH in participants aged 65 years and older.” 

In the analysis, men had a higher frequency of stage 2 SH associated with moderate drinking, compared with women who had a higher prevalence of stage 1 SH with moderate drinking. Overall, both groups had a higher incidence of all BP categories with heavy drinking.

Focusing on patient differences by race, a strong connection of heavy alcohol consumption with elevated stage 1 and stage 2 hypertension was observed among white and Black participants.

A comparable pattern was seen in Mexican American participants, with the exception for a nonsignificant, higher occurrence of elevated BP with heavy alcohol consumption. Black participants were the only group that had a higher occurrence of stage 1 and stage 2 hypertension with moderate alcohol consumption.

Aladin et al. emphasized that these findings have key "public health implications" that should be explored in detail. 

“Low to moderate alcohol consumption has consistently been shown to be associated with a reduced risk of cardiovascular disease and mortality," they wrote. "However, a recent study of nearly 600,000 subjects revealed that more than one drink/day was associated with increased all-cause mortality. Thus, the protective effect of low to moderate alcohol consumption needs to be reviewed carefully."

Read the full study here.

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