Association between Alcohol Consumption and Hypertension

Myoung Kyun Son

doi:10.5646/jksh.2011.17.2.65

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Son: Association between Alcohol Consumption and Hypertension

Original Article

J Korean Soc Hypertens 2011;17(2):65-73.

Published online: 10 June 2011

DOI: https://doi.org/10.5646/jksh.2011.17.2.65

Association between Alcohol Consumption and Hypertension

Myoung Kyun Son, MD

Department of Internal Medicine, Planned Population Federation of Korea, Incheon, Korea

Department of Internal Medicine, Planned Population Federation of Korea, Ganseok 3-dong, Namdong-gu, Incheon 405-800, Korea Tel: +82-32-451-4027, +82-10-9946-4771, Fax: +82-32-451-4099

Received 5 February 201125 April 2011 Accepted 29 April 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background:

Heavy alcohol consumption increases the risk of hypertension, but the effect of light to moderate alcohol consumption on the risk of hypertension remains controversial. In this cross-sectional study we aimed to identify the association between alcohol consumption and hypertension, and verify whether this association is influenced by age.

Methods:

Study participants were 498 men and 610 women, aged 23 to 88 years, who underwent periodic health examinations at one institute in Incheon, Korea.

Results:

Compared with nondrinkers, multivariate-adjusted odds ratio (OR) (95% confidence interval, CI) for hypertension according to the number of standard drinks consumed weekly was as follows: 1 to 3 drinks, OR =1.13 (95% CI, 0.56–2.29); 4 to 10 drinks, OR=0.51 (95% CI, 0.27–0.97); 11 to 18 drinks, OR=1.11 (95% CI, 0.55–2.20); ≥ 19 drinks per week, OR = 1.97 (95% CI, 1.18–3.29). A positive association between the prevalence of hypertension and alcohol consumption of ≥ 19 drinks per week was found for patients aged ≥ 60 years (OR = 2.47; 95% CI, 1.21–5.05), but not in patients aged < 60 years (OR = 1.54; 95% CI, 0.72–3.32). Light to moderate alcohol consumption from 4 to 10 drinks per week was significantly associated with a decreased risk of hypertension in subjects aged < 60 years (OR= 0.32; 95% CI, 0.11–0.97), but not in subjects aged ≥ 60 years (OR = 0.70; 95% CI, 0.31–1.58).

Conclusions:

Light to moderate alcohol consumption can decrease the risk of hypertension, whereas heavy alcohol intake is associated with an increased risk of hypertension. The association between alcohol consumption and hypertension may be changed by age.

Keywords: Alcohol drinking, Hypertension, Age factors, Coronary disease

References

1. MacMahon S. Alcohol consumption and hypertension. Hypertension. 1987; 9:111–21.

2. Thadhani R, Camargo CA Jr, Stampfer MJ, Curhan GC, Willett WC, Rimm EB. Prospective study of moderate alcohol consumption and risk of hypertension in young women. Arch Intern Med. 2002; 162:569–74.

3. Klatsky AL, Koplik S, Gunderson E, Kipp H, Friedman GD. Sequelae of systemic hypertension in alcohol abstainers, light drinkers, and heavy drinkers. Am J Cardiol. 2006; 98:1063–8.

4. Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: The Atherosclerosis Risk in Communities Study. Hypertension. 2001; 37:1242–50.

5. Klatsky AL. Alcohol and hypertension. Clin Chim Acta. 1996; 246:91–105.

6. Marmot MG, Elliott P, Shipley MJ, Dyer AR, Ueshima H, Beevers DG, et al. Alcohol and blood pressure: the INTERSALT study. BMJ. 1994; 308:1263–7.

7. Witteman JC, Willett WC, Stampfer MJ, Colditz GA, Kok FJ, Sacks FM, et al. Relation of moderate alcohol consumption and risk of systemic hypertension in women. Am J Cardiol. 1990; 65:633–7.

8. Xin X, He J, Frontini MG, Ogden LG, Motsamai OI, Whelton PK. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2001; 38:1112–7.

9. Gillman MW, Cook NR, Evans DA, Rosner B, Hennekens CH. Relationship of alcohol intake with blood pressure in young adults. Hypertension. 1995; 25:1106–10.

10. Ohmori S, Kiyohara Y, Kato I, Kubo M, Tanizaki Y, Iwamoto H, et al. Alcohol intake and future incidence of hypertension in a general Japanese population: the Hisayama study. Alcohol Clin Exp Res. 2002; 26:1010–6.

11. Wakabayashi I, Araki Y. Influences of gender and age on relationships between alcohol drinking and atherosclerotic risk factors. Alcohol Clin Exp Res. 2010; 34(Suppl 1):S54–60.

12. Canonico V. De Caprio L, Vigorito C, Forgione L, Tedeschi C, Guarini P, et al. Differences in blood pressure profile between young and elderly hypertensive patients. J Hum Hypertens. 1990; 4:405–9.

13. Chobanian AV. Treatment of the elderly hypertensive patient. Am J Med. 1984; 77:22–7.

14. Folkow B. Pathophysiology of hypertension: differences between young and elderly. J Hypertens Suppl. 1993; 11:S21–4.

15. Furmaga EM, Murphy CM, Carter BL. Isolated systolic hypertension in older patients. Clin Pharm. 1993; 12:347–58.

16. Fortmann SP, Haskell WL, Vranizan K, Brown BW, Farquhar JW. The association of blood pressure and dietary alcohol: differences by age, sex, and estrogen use. Am J Epidemiol. 1983; 118:497–507.

17. Wakabayashi I, Kobaba-Wakabayashi R. Effects of age on the relationship between drinking and atherosclerotic risk factors. Gerontology. 2002; 48:151–6.

18. Criqui MH. Alcohol and hypertension: new insights from population studies. Eur Heart J. 1987; 8(Suppl B):19–26.

19. Potter JF, Beevers DG. Pressor effect of alcohol in hypertension. Lancet. 1984; 1:119–22.

20. Potter JF, Watson RD, Skan W, Beevers DG. The pressor and metabolic effects of alcohol in normotensive subjects. Hypertension. 1986; 8:625–31.

21. Arkwright PD, Beilin LJ, Vandongen R, Rouse IL, Masarei JR. Plasma calcium and cortisol as predisposing factors to alcohol related blood pressure elevation. J Hypertens. 1984; 2:387–92.

22. Abe H, Kawano Y, Kojima S, Ashida T, Kuramochi M, Matsuoka H, et al. Biphasic effects of repeated alcohol intake on 24-hour blood pressure in hypertensive patients. Circulation. 1994; 89:2626–33.

23. Markovitz JH, Matthews KA, Kannel WB, Cobb JL, D’Agostino RB. Psychological predictors of hypertension in the Framingham Study. Is there tension in hypertension? JAMA. 1993; 270:2439–43.

24. Beilin LJ, Puddey IB, Burke V. Alcohol and hypertension–kill or cure? J Hum Hypertens. 1996; 10(Suppl 2):S1–5.

25. Britton A, Marmot M. Different measures of alcohol consumption and risk of coronary heart disease and all-cause mortality: 11-year follow-up of the Whitehall II Cohort Study. Addiction. 2004; 99:109–16.

26. Palmer AJ, Fletcher AE, Bulpitt CJ, Beevers DG, Coles EC, Ledingham JG, et al. Alcohol intake and cardiovascular mortality in hypertensive patients: report from the Department of Health Hypertension Care Computing Project. J Hypertens. 1995; 13:957–64.

27. Cleophas TJ. Wine, beer and spirits and the risk of myocardial infarction: a systematic review. Biomed Pharma-cother. 1999; 53:417–23.

28. Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ. 1996; 312:731–6.

29. Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med. 1988; 319:267–73.

30. Hansen AS, Marckmann P, Dragsted LO, Finne Nielsen IL, Nielsen SE, Gronbaek M. Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease. Eur J Clin Nutr. 2005; 59:449–55.

31. Langer RD, Criqui MH, Reed DM. Lipoproteins and blood pressure as biological pathways for effect of moderate alcohol consumption on coronary heart disease. Circulation. 1992; 85:910–5.

32. Naissides M, Mamo JC, James AP, Pal S. The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women. Atherosclerosis. 2006; 185:438–45.

33. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999; 319:1523–8.

34. Leighton F, Miranda-Rottmann S, Urquiaga I. A central role of eNOS in the protective effect of wine against metabolic syndrome. Cell Biochem Funct. 2006; 24:291–8.

35. Leikert JF, Rathel TR, Wohlfart P, Cheynier V, Vollmar AM, Dirsch VM. Red wine polyphenols enhance endothelial nitric oxide synthase expression and subsequent nitric oxide release from endothelial cells. Circulation. 2002; 106:1614–7.

36. Bulpitt CJ. How many alcoholic drinks might benefit an older person with hypertension? J Hypertens. 2005; 23:1947–51.

37. Fuchs CS, Stampfer MJ, Colditz GA, Giovannucci EL, Manson JE, Kawachi I, et al. Alcohol consumption and mortality among women. N Engl J Med. 1995; 332:1245–50.

38. Jackson R, Beaglehole R. Alcohol consumption guidelines: relative safety vs absolute risks and benefits. Lancet. 1995; 346:716.

39. Hart CL, Smith GD, Hole DJ, Hawthorne VM. Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of scottish men with 21 years of follow up. BMJ. 1999; 318:1725–9.

40. McKee M, Britton A. The positive relationship between alcohol and heart disease in eastern Europe: potential physiological mechanisms. J R Soc Med. 1998; 91:402–7.

41. Stranges S, Wu T, Dorn JM, Freudenheim JL, Muti P, Farinaro E, et al. Relationship of alcohol drinking pattern to risk of hypertension: a population-based study. Hypertension. 2004; 44:813–9.

42. Schulze MB, Kroke A, Bergmann MM, Boeing H. Differences of blood pressure estimates between consecutive measurements on one occasion: implications for inter-study comparability of epidemiologic studies. Eur J Epidemiol. 2000; 16:891–8.

43. Ahn JH, Shin CS, Kim SY, Park YB, Cho BY, Lee HK, et al. Prevalence and associated factors of elevated blood pressure in Yonchon county. J Korean Soc Hypertens. 1997; 3:77–83.

Table 1.

Comparison of clinical characteristics between the subjects with and without hypertension

Variables	Hypertension (n = 236)	Normotension (n = 872)	p-value
Men/women	128/108 (54.2/45.8)	370/502 (42.4/57.6)	0.001^*
Age (yr)	62.6 ± 11.2	56.2 ± 11.6	<0.001^†
FBS (mg/dL)	105.3 ± 27.2	99.8 ± 24.4	0.003^†
HDL‐C (mg/dL)	48.5 ± 12.2	51.4 ± 12.8	0.002^†
LDL‐C (mg/dL)	118.7 ± 31.3	116.4 ± 32.2	0.326^†
BMI (kg/m²)	24.3 ± 3.1	23.6 ± 3.0	<0.001^†
Alcohol intake (drink/wk)			0.007^*
0	161 (68.2)	602 (69.0)
1-3	12 (5.1)	47 (5.4)
4-10	13 (5.5)	95 (10.9)
11-18	13 (5.5)	51 (5.8)
≥19	37 (15.7)	77 (8.8)
Drinking frequency (day/wk)			0.038^*
0	(68.2) 161	(69.0) 602
1-2	(14.0) 33	(18.7) 163
≥3	42 (17.8)	(12.3) 107
Drinking quantity (drink/day)			0.944^*
0	(68.2) 161	602 (69.0)
1-6	(16.1) 38	141 (16.2)
≥7	(15.7) 37	129 (14.8)
Smoking			0.056^*
Nonsmoker	143 (60.6)	(68.0) 593
Ex-smoker	45 (19.1)	118 (13.5)
Current smoker	48 (20.3)	161 (18.5)
Regular exerciser	46 (19.5)	172 (19.7)	0.936^*

Values were presented by mean±standard deviation or number (%).

FBS, fasting blood sugar; HDL‐C, high density lipoprotein-cholesterol; LDL‐C, low density lipoprotein cholesterol; BMI, body mass index.

p-values were obtained by

^* Pearson’s chi-square test or

^† Student t test.

Table 2.

Association between alcohol consumption and risk of hypertension by logistic regression analysis

Alcohol intake (drink/wk)	Unadjusted		Model 1^*		Model 2^††
Alcohol intake (drink/wk)	OR (95% CI)	p-value^‡	OR (95% CI)	p-value^‡	OR (95% CI)	p-value^‡
0^§ (n=763)	1.00		1.00		1.00
1-3 (n=59)	0.96 (0.50-1.84)	0.890	1.06 (0.54-2.11)	0.865	1.13 (0.56-2.29)	0.726
4-10 (n=108)	0.51 (0.28-0.94)	0.030	0.49 (0.26-0.93	) 0.028	0.51(0.27-0.97)	0.040
11-18 (n=64)	0.95 (0.51-1.80)	0.882	0.98 (0.50-1.90)	) 0.943	1.11 (0.55-2.20)	0.777
≥19 (n=114)	1.80 (1.17-2.76)	0.007	1.79 (1.11-2.90)	0.018	1.97 (1.18-3.29)	0.010

OR, odds ratio; CI, confidence interval.

^* Adjusted for age and sex.

^† Adjusted for age, sex, BMI, FBS, HDL‐C, LDL‐C, smoking status, and physical activity.

^‡ P values were obtained by logistic regression analysis.

^§ Reference category.

Table 3.

Association between alcohol consumption and risk of hypertension by age-specific logistic regression analysis

Alcohol intake (drink/wk)	Unadjusted		Model 1^*		Model 2^††
Alcohol intake (drink/wk)	OR (95% CI)	p-value^‡	OR (95% CI)	p-value^‡	OR (95% CI)	p-value^‡
Age ≥60 yr
0^§ (n=357)	1.00		1.00		1.00
1-3 (n=17)	1.70 (0.63-4.59)	0.293	1.68 (0.62-4.56)	0.313	1.77 (0.63-4.95)	0.280
4-10 (n=40)	0.71 (0.33-1.54)	0.380	0.69 (0.31-1.54)	0.362	0.70 (0.31-1.58)	0.387
11-18 (n=29)	0.77 (0.32-1.87)	0.569	0.76 (0.31-1.86)	0.544	0.82 (0.32-2.09)	0.679
≥19 (n=45)	2.13 (1.14-3.99)	0.018	2.07 (1.06-4.05)	0.034	2.47 (1.21-5.05)	0.013
Age <60 yr
0^§ (n=406)	1.00		1.00		1.00
1-3 (n=42)	0.83 (0.31-2.19)	0.703	0.77 (0.29-2.05)	0.600	0.88 (0.33-2.39)	0.807
4-10 (n=68)	0.38 (0.13-1.09)	0.072	0.30 (0.10-0.89)	0.029	0.32 (0.11-0.97)	0.043
11-18 (n=35)	1.27 (0.50-3.19)	0.615	1.00 (0.38-2.60)	1.000	1.20 (0.44-3.26)	0.728
≥19 (n=69)	1.85 (0.99-3.45)	0.054	1.40 (0.70-2.78)	0.340	1.54 (0.72-3.32)	0.268

OR, odds ratio; CI, confidence interval.

^* Adjusted for sex.

^† Adjusted for sex, BMI, FBS, HDL‐C, LDL‐C, smoking status, and physical activity.

^‡ p‐values were obtained by logistic regression analysis.

^§ Reference category.

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