Effects of Habitual Alcohol Intake on Ambulatory Blood Pressure, Heart Rate, and Its Variability Among Japanese Men

Abstract

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...

Ethnic Differences in the Degree of Morning Blood Pressure Surge and in Its Determinants Between Japanese and European Hypertensive Subjects

“…In this study, sleep-trough BP MS was higher than that in the European hypertensive patients in our study (33 mm Hg), even though Ohasama study included subjects from a general population with lower age (mean 61 years) and lower 24-hour BP levels (mean 123/72 mm Hg). 11 On the contrary, in the study by Ohira et al, 29 the top decile of the MS distribution was almost superimposable to that of our European hypertensive patients. It has to be emphasized, however, that this Japanese population was much younger and had much lower 24-hour BP levels and that MS was computed by considering as night-time value the average night-time SBP instead of the 3 consecutive readings centered on the lowest reading during sleep, possibly leading to MS underestimation.…”

Chronic Kidney Disease and Drinking Status in Relation to Risks of Stroke and Its Subtypes

“…In contrast, heavy alcohol drinking increases not only blood pressure levels, but also blood pressure variability including the morning surge, 27 which increases risk of hemorrhagic stroke. 28 Therefore, the association between CKD and hemorrhagic stroke may be stronger among drinkers.…”

Impact of outdoor temperature on prewaking morning surge and nocturnal decline in blood pressure in a Japanese population

“…Previous studies demonstrated that habitual alcohol intake was associated with increased BP in the morning. 28 Therefore, further study is necessary to clarify the effect of alcohol intake on D prewaking morning BP surge. Finally, we could not obtain information regarding the indoor temperature.…”