Increased risk of hypertension with moderate and heavy alcohol consumption
Association of Alcohol Intake With Hypertension in Type 2 Diabetes Mellitus:The ACCORD Trial
Introduction and methods
It has been known for years that high alcohol intake is associated with hypertension. Light and moderate consumption of alcohol, however, does not show an association with hypertension and even has been associated with improved CV outcomes when compared with abstainers [1-4]. CV benefit by light and moderate alcohol intake may be mediated via decreased atherosclerosis, blood clotting and platelet aggregation and therefore some have recommended light to moderate alcohol consumption as beneficial and cardioprotective [5,6]. Other studies, more recent ones, identified a linear relationship identified for the amount of alcohol consumption and the degree of hypertension [7,8].
In this study the association of alcohol consumption and hypertension was examined in participants of the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes, ). In the ACCORD trial, 10251 type 2 diabetes patients were enrolled, who either had high risk of CVD or established CVD. This analysis included those who had baseline self-reported alcohol consumption and baseline blood pressure measurements, leaving 102000 participants. Light, moderate, and heavy alcohol consumption were defined as 1 to 7 drinks/week, 8 to 14 drinks/ week, and ≥15 drinks/week, respectively. A drink was defined as a 12-ounce beer, 6 ounces of wine, or 1.5 ounces of liquor. Blood pressure was categorized according to the ACC/AHA 2017 guidelines.
- The distribution of alcohol intake in this cohort was as follows: none n=7767, light n=2124, moderate n=232, heavy n=77.
- Light alcohol consumption was not associated with elevated blood pressure (OR 1.11, 95%CI: 0.93-1.13, P=0.25) (those who had no alcohol intake were the referent group). Moderate and heavy alcohol consumption were associated with elevated blood pressure (OR 1.79, 95%CI: 1.04-3.11, P=0.03 and OR 1.91, 95%CI: 1.17-3.12, P=0.01).
- There was no association with light alcohol consumption and stage 1 hypertension (OR 1.11, 95%CI: 0.85-1.45, P=0.45). Moderate and heavy alcohol consumption were associated with stage 1 hypertension (OR 1.66, 95%CI; 1.05-2.60, P=0.03, and OR 2.49, 95%CI: 1.03-6.17, P=0.03).
- Light alcohol consumption was not associated with stage 2 hypertension (OR 1.02, 95%CI:0.88-1.19, P=0.76). Moderate and heavy alcohol consumption were associated with stage 2 hypertension (OR 1.62, 95%CI; 1.03-2.54, P-0.03 and OR 3.04, 95%CI: 1.28-7.22, P=0.01).
In this cohort of T2DM patients with high CV risk, who participated in the ACCORD trial, moderate (>7 drinks per week) and heavy alcohol consumption was associated with elevated blood pressure, stage 1 and stage 2 hypertension.