Higher Prevalence of Systemic Hypertension Among Moderate Alcohol Drinkers: An Exploration of the Role of Underreporting

Klatsky, Arthur L.; Gunderson, Erica P.; Kipp, Harald; Udaltsova, Natalia; Friedman, Gary D.

doi:10.15288/jsa.2006.67.421

Cited by 54 publications

(30 citation statements)

References 18 publications

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“…18,19 Any alcohol misclassification is likely random, biasing our RRs toward the null, although differential underreporting may occur among moderate drinkers. 34 We lacked beverage-specific intake in men, yet the effects of alcohol are driven by its ethanol content. 35 Summing 4 individual alcoholic beverages may explain why proportionately more women drank heavily than men.…”

Section: Discussionmentioning

confidence: 99%

Alcohol Consumption and the Risk of Hypertension in Women and Men

et al. 2008

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Abstract-Heavy alcohol intake increases the risk of hypertension, but the relationship between light-to-moderate alcohol consumption and incident hypertension remains controversial. We prospectively followed 28 848 women from the Women's Health Study and 13 455 men from the Physicians' Health Study free of baseline hypertension, cardiovascular disease, and cancer. Self-reported lifestyle and clinical risk factors were collected. In women, total alcohol intake was summed from liquor, red wine, white wine, and beer; men reported total alcohol intake from a single combined question. During 10.9 and 21.8 years of follow-up, 8680 women and 6012 men developed hypertension (defined as new physician diagnosis, antihypertensive treatment, reported systolic blood pressure Ն140 mm Hg, or diastolic blood pressure Ն90 mm Hg). In women, we found a J-shaped association between alcohol intake and hypertension in age-and lifestyle-adjusted models. Adding potential intermediates (body mass index, diabetes, and high cholesterol) attenuated the benefits of alcohol in the light-to-moderate range and strengthened the adverse effects of heavy alcohol intake. Beverage-specific relative risks paralleled those for total alcohol intake. In men, alcohol intake was positively and significantly associated with the risk of hypertension and persisted after multivariate adjustment. Models stratified by baseline systolic blood pressure (Ͻ120 versus Ն120 mm Hg) or diastolic blood pressure (Ͻ75 versus Ն75 mm Hg) did not alter the relative risks in women and men. In conclusion, light-to-moderate alcohol consumption decreased hypertension risk in women and increased risk in men. The threshold above which alcohol became deleterious for hypertension risk emerged at Ն4 drinks per day in women versus a moderate level of Ն1 drink per day in men. Key Words: alcohol Ⅲ hypertension Ⅲ blood pressure Ⅲ prospective study Ⅲ men Ⅲ women C onsiderable evidence supports an association between excessive alcohol intake and an increased risk of hypertension. [1][2][3] This association persists regardless of beverage type, 4 implicating ethanol in this etiologic process, although few studies have compared beverage types. 5,6 A meta-analysis of randomized clinical trials among subjects initially consuming 3 to 6 drinks per day found that reductions in alcohol intake significantly decreased both systolic and diastolic blood pressure (BP; SBP and DBP, respectively). 7 Clinically meaningful BP reductions occur within weeks after reductions in alcohol intake among hypertensive subjects, 8 but few data exist among normotensive individuals.Clinical guidelines on the primary prevention of hypertension recommend limiting alcohol intake Յ2 drinks per day in men and Յ1 drink per day in women. 9,10 However, uncertainty remains regarding any benefits or risks attributable to light-to-moderate alcohol intake on the risk of hypertension. Conflicting studies have noted beneficial, 6 unassociated, 2,3,5,11 and deleterious 12,13 effects on the risk of hypertension or elevations in BP. ...

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Section: Discussionmentioning

confidence: 99%

Alcohol Consumption and the Risk of Hypertension in Women and Men

et al. 2008

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“…French subjects consuming alcohol moderately would have a very shrewd idea of how much they consumed. Klatsky and his colleagues have estimated that the increased odds ratio for hypertension in persons reporting one to two drinks per day appears to be due, in part, to under-reporting (17).…”

Section: Discussionmentioning

confidence: 99%

Patterns of Alcohol Consumption and Cardiovascular Risk in Northern Ireland and France

Ae¹,

Marques‐Vidal²,

Ducimetière³

et al. 2007

Annals of Epidemiology

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“…Relevant to the issue of alcohol threshold is the suggestion that heavy alcohol intake may be underreported [30], thus possibly invalidating the apparent increased HTN risk of lighter drinkers. Underreporting of alcohol intake places some heavier drinkers in lighter categories, a misclassification that lowers the threshold of apparent harm.…”

Section: Systemic Htnmentioning

confidence: 99%

Alcohol and cardiovascular diseases: where do we stand today?

2015

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Abstract. Klatsky AL (Northern California Kaiser Permanente, Oakland, CA, USA). Alcohol and cardiovascular diseases: where do we stand today?. (Review). J Intern Med 2015;278: 238-250.For centuries, multiple medical risks of heavy alcohol drinking have been evident with simultaneous awareness of a less harmful or sensible drinking limit. The increased risks of heavy drinking, defined as three or more standard-sized drinks per day, are both cardiovascular (CV) and non-CV. The CV risks include the following: (i) alcoholic cardiomyopathy (ACM), (ii) systemic hypertension, (iii) atrial arrhythmias, (iv) haemorrhagic stroke and, probably, ischaemic stroke. By contrast, modern epidemiological studies have shown lower morbidity and mortality amongst light-moderate drinkers, due mostly to a reduced risk of coronary artery disease (CAD), with contributions from ischaemic stroke and heart failure (HF). A low level of alcohol drinking has no clear relation to increased risk of any CV condition, except for haemorrhagic stroke. There is good evidence that supports the existence of mechanisms by which alcohol might protect against CAD, but the mechanisms for other alcohol-CV associations remain unclear. Interrelationships amongst the CV conditions affect the individual alcohol-disease relationships; for example, lower CAD risk in lightmoderate drinkers is to a large extent responsible for the reduced HF risk. International comparison data plus the presence of proposed beneficial nonalcohol components in wine (particularly in red wine) suggest that this beverage type might afford extra CAD protection. However, the effect of beverage choice is confounded by a healthier drinking pattern and more favourable risk traits in wine drinkers. Debate persists about methodological and public health issues related to the epidemiology of alcohol-related CV disease.

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Higher Prevalence of Systemic Hypertension Among Moderate Alcohol Drinkers: An Exploration of the Role of Underreporting

Cited by 54 publications

References 18 publications

Alcohol Consumption and the Risk of Hypertension in Women and Men

Alcohol Consumption and the Risk of Hypertension in Women and Men

Patterns of Alcohol Consumption and Cardiovascular Risk in Northern Ireland and France

Alcohol and cardiovascular diseases: where do we stand today?

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