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To investigate the time course of the effects of alcohol on blood pressure, we studied the response of ambulatory blood pressure, neurohumoral variables, and hemodynamics to a single moderate dose of alcohol in hypertensive patients. Sixteen Japanese men (22-70 years old) with essential hypertension who were habitual drinkers were examined under standardized conditions. On the alcohol intake day, they ingested 1 ml/kg ethanol (vodka) at dinner, and on the control day they consumed a nonalcoholic beverage. The order of the two periods was randomized. Mean ambulatory blood pressure was lower in the alcohol intake period than in the control period (125±3/74±2 versus 132±4/78±2 mm Hg,p<0.05), and the significant depressor effect of alcohol lasted for up to 8 hours after drinking. Blood pressure on the next day did not differ with or without alcohol intake. The acute hypotensive effect of alcohol was associated with an increase in heart rate and cardiac output and with a decrease in systemic vascular resistance as determined by echocardiography. Plasma catecholamlne levels and renin activity rose significantly at 2 hours after dinner, whereas vasopressin and potassium levels fell on the alcohol day. Blood glucose and serum insulin levels were comparable between the two periods. Three patients with marked alcohol-induced flush had greater hypotensive and tachycardic responses than those who did not show an alcohol-induced flush. The change in mean blood pressure induced by alcohol was negatively correlated with age, the baseline blood pressure, and the change in plasma norepinephrine. These results indicate that the major effect of acute alcohol intake is to lower blood pressure through systemic vasodilatation in hypertensive subjects. Ambulatory blood pressure monitoring may be useful for assessing blood pressure in habitual drinkers. T he relation between alcohol and hypertension is well known. A positive association between the level of habitual alcohol intake and blood pressure has been shown in many reports, 1 " 5 and this relation has been observed in whites, blacks, and Asians. It has also been reported that abstinence from alcohol results in a decrease of blood pressure in drinkers. 6 -9 However, these observations depended on casual blood pressure measurements taken in the daytime, while most habitual drinkers consume alcohol in the evening and at night. Alcohol has an acute vasodilatory action, 1011 and it has been our experience that many hypertensive patients note a decrease in their blood pressure after alcohol ingestion at home. It has been recommended that the relation between the time of the last alcohol intake and that of blood pressure measurement should be considered, 2 but this has generally been ignored. Inconsistent results have been reported about

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