The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults

Abstract

Given the dynamic characteristic of an individual’s drinking behaviors, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5.3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the 3rd visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2.9 mmHg, p-value = 0.032) and -adjusted models (3.6 mmHg, p-value = 0.001) and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3.9 mmHg, p-value = 0.003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption than the trajectory may be significantly related to raised SBP and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP adjusted in men.

Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies

“… Dose-response relationship between baseline alcohol intake and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in all cohort studies. 11,20,21,23–26 Spline curve (solid line) with 95% confidence limits (gray area).…”

“…Details of the risk of bias assessment are reported in Table S2. Two studies were categorized as having a low risk of bias, 11,24 4 as having a moderate risk, 20,21,23,26 and the remaining one as having a high risk of bias. 25 As shown in Figure S1, forest-plots comparing the highest versus the lowest category of alcohol intake demonstrated an increased mean difference for SBP and DBP (mean difference, +4.30 mm Hg [95% CI, −2.76 to +5.85] with I 2 =67.11%, and +2.42 mm Hg [95% CI, +1.13 to +3.71] with I 2 =78.45%, respectively).…”

“…7 One of the 2 meta-analyses of clinical trials identified no effect on SBP or DBP when the baseline average participant intake of alcohol was ≤2 drinks per day, whereas a dose-dependent reduction in BP was noted in those with a higher baseline alcohol intake. 5 The second report, which included a smaller number of trials and relied on a meta-regression Studies conducred in Asia (A and B) 11,[24][25][26] and North America (C and D). 20,21,23 linear model, found the percentage of alcohol consumption reduction to be strongly and positively associated with corresponding reductions in both SBP and DBP, with no substantial effect of the duration of the intervention.…”

“…Figure 4. Dose-response relationship of baseline alcohol intake with systolic blood pressure (SBP) and diastolic blood pressure (DBP) divided by region.Studies conducred in Asia (A and B)11,[24][25][26] and North America (C and D) 20,21,23. Spline curve (solid line) with 95% confidence limits (gray area).…”

“… 5 , 7 – 9 The body of evidence detailing the effects of changes in alcohol intake on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in persons who were initially consuming light to moderate amounts of alcohol is limited, with neither systematic reviews or meta-analyses being available on this topic. Longitudinal studies on the association between low intakes of alcohol and BP have been published recently, 10 , 11 and a new statistical meta-analytic technique that allows for a comprehensive exploration of dose-response relationships, the so-called 1-stage dose-response meta-analysis for aggregated data, has recently been reported. 12 This technique allows inclusion of studies in the dose-response analysis even when as few as 2 categories of exposure have been assessed, 13 , 14 preserving any study-specific structure of contrasts in the estimation of the dose-response relationship within a single model.…”