Alcohol Use Associated With Poor Blood Pressure, Even After Controlling for Other Risk Factors

Alcohol use is positively associated with blood pressure, and is a risk factor for poor blood pressure control among people with established hypertension. However, the mechanism by which alcohol use is related to worse blood pressure control has not been fully characterized. Researchers assessed the potential mediating roles of several behavior-related risk factors that are associated with poor blood pressure control among 1835 persons with hypertension (51% women, 58% Black) participating in the longitudinal Coronary Artery Risk Development in Young Adults cohort study (2005–2016).

• Each additional drink per day of average consumption was associated with 0.71 mmHg higher systolic blood pressure (95% confidence interval [CI], 0.40, 1.03) and 0.36 mmHg higher diastolic blood pressure (95% CI, 0.16, 0.56).
• After adjusting for average daily alcohol consumption, heavy episodic drinking (defined as consuming ≥5 drinks at least once in the last 30 days) was not independently associated with blood pressure.
• The alcohol-blood pressure relationship was not mediated by smoking, physical inactivity, unhealthy diet, or poor medication adherence.

Comments: In this cohort, the relationship between increased alcohol use and higher blood pressure among individuals with hypertension was not mediated by common associated behavior-related risk factors, supporting a primary direct effect of alcohol on blood pressure. Addressing alcohol use is an important component of managing patients with hypertension.

Timothy S. Naimi, MD, MPH

Reference: Phillips AZ, Kiefe CI, Lewis CE, et al. Alcohol use and blood pressure among adults with hypertension: the mediating roles of health behaviors. J Gen Intern Med. 2022 [Epub ahead of print]. doi: 10.1007/s11606-021-07375-3.