Pressor Effect of Alcohol in Hypertension

Potter, JF; Beevers, D. G.

doi:10.1016/s0140-6736(84)90060-6

Cited by 269 publications

(143 citation statements)

References 12 publications

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“…Howes and Reid, 67 observed a BP increase after repeated alcohol consumption for 7 days in normotensive subjects. Potter and Beevers, 68 reported a BP increase after alcohol intake for 4 days in hypertensive patients. Using a crossover design, Puddey et al 69,70 compared BP values during a 6-week period of unrestricted alcohol consumption and that of alcohol restriction in normotensive and hypertensive subjects.…”

Section: Clinical Studiesmentioning

confidence: 97%

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

Kawano

2010

Hypertens Res

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Alcohol has complex effects on the cardiovascular system. The purpose of this article is to review physio-pathological effects of alcohol on cardiovascular and related systems and to describe its role in hypertension and cardiovascular disease. The relationship between alcohol and hypertension is well known, and a reduction in the alcohol intake is widely recommended in the management of hypertension. Moreover, alcohol has both pressor and depressor actions. The latter actions are clear in Oriental subjects, especially in those who show alcohol flush because of the genetic variation in aldehyde dehydrogenase activity. Repeated alcohol intake in the evening causes an elevation in daytime and a reduction in nighttime blood pressure (BP), with little change in the average 24-h BP in Japanese men. Thus, the hypertensive effect of alcohol seems to be overestimated by the measurement of casual BP during the day. Heavy alcohol intake seems to increase the risk of several cardiovascular diseases, such as hemorrhagic stroke, arrhythmia and heart failure. On the other hand, alcohol may act to prevent atherosclerosis and to decrease the risk of ischemic heart disease, mainly by increasing HDL cholesterol and inhibiting thrombus formation. A J-or U-shaped relationship has been observed between the level of alcohol intake and risk of cardiovascular mortality and total mortality. It is reasonable to reduce the alcohol intake to less than 30 ml per day for men and 15 ml per day for women in the management of hypertension. As a small amount of alcohol seems to be beneficial, abstinence from alcohol is not recommended to prevent cardiovascular disease. INTRODUCTIONAlcohol has complex effects on the cardiovascular system. The relationship between alcohol and hypertension is well known, and a restriction of alcohol intake is widely recommended as a part of lifestyle modifications in the management of hypertension. 1-6 Alcohol has both pressor and depressor actions, however, and the genetic susceptibility regarding alcohol metabolism influences the cardiovascular effect of alcohol. 3,7 The effect of alcohol on blood pressure (BP) is also modified by several factors, such as the level of consumption, time period after the last drink and overall drinking behavior.Alcohol consumption is associated with several cardiovascular diseases, such as brain hemorrhage, heart failure and arrhythmia, as well as with other disorders. 3,[8][9][10][11] Heavy drinking and alcoholism not only lead to medical problems but are also serious social concerns. However, alcohol also seems to have beneficial effects, including the prevention of ischemic heart disease. It has been shown that cardiovascular and all-cause mortality is lower in light drinkers compared with nondrinkers. 3,[8][9][10][11][12] The purpose of this article is to review physio-pathological effects of alcohol on cardiovascular and related systems and to describe its role

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Section: Clinical Studiesmentioning

confidence: 97%

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

Kawano

2010

Hypertens Res

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“…The above-mentioned studies 11,[14][15][16] and intervention studies [18][19][20][21][22][23] indicate that an increase in alcohol consumption is associated with a significant increase in blood pressure, whereas decreased alcohol consumption is associated with a significant decrease in blood pressure in the subjects including hypertensive participants. In this study, we found that changes in alcohol consumption linearly associated with changes in blood pressure even in normotensive subjects.…”

Section: Journal Of Human Hypertensionmentioning

confidence: 99%

Alcohol consumption and blood pressure change: 5-year follow-up study of the association in normotensive workers

et al. 2001

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This study endeavours to clarify the effect of alcohol consumption on changes in the blood pressure of Japanese men. The subjects, who were followed from 1990 to 1995, were 2189 male normotensive steelworkers aged from 40 to 54 years in 1990. Drinking habits were represented by two variables: average daily baseline alcohol consumption, and change in alcohol consumption during the observation period, both derived from self-report questionnaires and interviews. Nine other items were analysed as covariates: systolic and diastolic blood pressure, age, body mass index (BMI), salt intake, physical activity, and levels of gamma glutamyl transpeptidase (GTP), uric acid and plasma glucose in 1990. The association between drinking habits and blood pressure was evaluated using ANCOVA. Subjects who had initiated antihypertensive therapy by 1995 were excluded from this dataset. The results of analysis dis-

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“…8 -11 This effect, however, requires at least days to develop, 10 and it is not known whether it contributes to the negative effect of alcohol intake on antihypertensive therapy in treated hypertensive patients. Puddey et al 6 have shown that reduction of alcohol intake in treated hypertensive patients resulted in a significant lowering of blood pressure during a 6-week trial period.…”

Section: Reversal By Ethanol Of the Hypotensive Effect Of Clonidine Imentioning

confidence: 99%

Reversal by ethanol of the hypotensive effect of clonidine in conscious spontaneously hypertensive rats.

Abdel‐Rahman

1989

Hypertension

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We studied the acute effect of ethanol on the hypotensive response to clonidine in conscious spontaneously hypertensive rats. When administered during the hypotensive response to clonidine, ethanol not only reversed the response but also caused a slight but significant short-lived pressor effect. The maximal hypotensive effect of graded doses of clonidine was significantly (p<0.05) attenuated by a dose of 1 g/kg ethanol, which resulted in a peak blood ethanol concentration of 54.2 ±6.3 mg/dl. The data strongly suggest the adverse effect of ethanol on the hypotensive response to clonidine is ethanol mediated and that their antagonistic interaction is both reversible and reproducible because: 1) an equal volume of saline had no effect on the hemodynamic responses to clonidine and 2) crossing over ethanol and saline treatments on days 2 and 3, which allowed longitudinal comparisons, showed that the effect of ethanol was similar both in naive rats (day 1) and in rats that were pre-exposed to ethanol (day 3). Whether this negative effect of ethanol also involves other antihypertensive agents that do not act primarily by a central nervous system mechanism was investigated. The same dose of ethanol had little or no effect on the hypotensive response to hydralazine, suggesting the negative effect of ethanol is selective to centrally acting antihypertensive agents. Although the mechanism by which ethanol reverses the hypotensive effect of clonidine is not known, it is possible that it involves an ethanol-evoked increase in plasma catecholamine levels, which are known to be decreased by clonidine. That ethanol did not reverse the hypotensive effect of hydralazine, which is also known to be associated with increased plasma catecholamine levels, supports this notion. The findings of the present study may explain, at least in part, why regular use of alcohol is associated with an inadequate control of blood pressure in treated hypertensive patients who are regular consumers of alcohol. (Hypertension 1989;14:531-541)

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Pressor Effect of Alcohol in Hypertension

Cited by 269 publications

References 12 publications

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

Alcohol consumption and blood pressure change: 5-year follow-up study of the association in normotensive workers

Reversal by ethanol of the hypotensive effect of clonidine in conscious spontaneously hypertensive rats.

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