Abstract-We sought to examine effects of habitual alcohol intake on ambulatory blood pressure (BP), heart rate (HR), and HR variability among Japanese men. Subjects were 539 men aged 35 to 65 years from rural and urban communities. Ambulatory BP and HR were monitored with an automated, portable, noninvasive multibiomedical recorder. Power spectral analysis of the RR intervals on the ECG was performed every 5 minutes. Compared with nondrinkers, moderate drinkers (alcohol intake 23 to 45 g/d) and heavy drinkers (alcohol intake Ն46 g/d) showed higher age-and field-adjusted mean values of systolic and diastolic BPs during the morning and while awake, but there were no differences in BPs over 24-hour periods and while asleep among the alcohol intake categories. Alcohol intake was positively associated with mean values of sleep-morning differences and daytime variability in BPs, HRs while awake and asleep, and low frequency:high frequency ratio while asleep. The results were virtually unchanged after adjustment for body mass index, smoking, and diabetes mellitus. Compared with the nondrinkers, age-and field-adjusted odds ratios of the morning BP surge (excess elevation of BP in the morning: morning systolic BP minus sleep systolic BP Ն37 mm Hg) for light (alcohol intake 0 to 22 g/d), moderate, and heavy drinkers were 0.96 (95% CI: 0.34 to 2.78), 1.68 (95% CI: 0.64 to 4.38), and 2.73 (95% CI: 1.12 to 6.67), respectively. Habitual alcohol intake was associated with increased BP in the morning, HR while awake and asleep, and sympathetic activity while asleep, which may explain some of the mechanisms of the relationship between heavy alcohol intake and risk of cardiovascular diseases. Key Words: alcohol intake Ⅲ ambulatory blood pressure monitoring Ⅲ autonomic nerve function Ⅲ heart rate variability Ⅲ population-based .S everal prospective studies have reported that heavy alcohol intake increases the risk of stroke, 1-5 especially hemorrhagic stroke. 1-3 Because daily alcohol intake is positively associated with blood pressure (BP) levels, high BP is thought to be an important mediator between alcohol intake and the risk of stroke. However, although the associations of daily alcohol intake with casual BP are well documented, 6,7 the associations with 24-hour ambulatory BP are not, 7 because the effect of daily alcohol intake on BP depends on the time elapsed after alcohol intake. 8,9 Recent studies have indicated that morning BP surge, the excessive elevation of BP in the morning, could be associated with risk of stroke. 10,11 Kario et al showed that, in 519 Japanese older hypertensives, a higher morning BP surge was associated with a higher incidence of stroke independent of mean values of 24-hour systolic BP. 10 Another prospective study of 1430 Japanese men and women aged Ն40 years also found a positive association of morning BP surge with the incidence of hemorrhagic stroke after adjustment for 24-hour systolic BP and antihypertensive medication use but no association between morning BP surge and risk of ischemic stro...

A high sodium intake strengthens the association of ACE I/D polymorphism with BP levels in community-based samples.

BackgroundBrugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST‐segment elevation in the right precordial leads (STERP) and the long‐term prognosis for those patients remain unknown.Methods and ResultsWe analyzed standard 12‐lead ECGs of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP. The others served as the non–ST‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP. During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non–ST‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0).Conclusions STERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.

There have been few epidemiological studies on the gene-environmental interaction between the aldosterone synthase gene (CYP11B2) T-344C polymorphism and sodium in relation to blood pressure in a free-living general population. We hypothesized a priori that persons with the T allele of CYP11B2 would have elevated blood pressure levels in response to a higher sodium intake, and thus the association between the T-344C polymorphism and blood pressure would be more evident among persons with a high sodium intake than among those with a low sodium intake. Study subjects were 2,823 men and women aged 30-74 in a Japanese community. We examined the associations between the T-344C polymorphism and blood pressure levels, stratified by sodium variables estimated by 24-h urinary sodium excretion and a dietary questionnaire. There was no significant difference in blood pressure levels among the CC, TC and TT groups for either or both sexes. However, among persons with higher sodium excretion, mean systolic blood pressure levels tended to be higher in those with the TC (+3.0 mmHg, p=0.06) and TT (+2.9 mmHg, p=0.07) genotypes than in those with the CC genotype, but this tendency was not seen among those with lower sodium excretion (-4.0 mmHg, p=0.03 for TC vs. CC; -3.0 mmHg, p=0.11 for TT vs. CC; p for interaction =0.006). In conclusion, we found no association between CYP11B2 and blood pressure for total subjects or for persons with a higher sodium intake. However, a possible gene-blood pressure association among persons with higher sodium intake needs to be explored further.