Alcohol, Hypertension, and Cardiovascular Disease Mortality

Heavy drinking
is associated with dose-dependent increases in blood pressure.
However, the relationship between drinking and mortality among
patients with hypertension is unclear. To assess this relationship,
researchers used self-reported data from 14,125 male participants
in the Physicians’ Health Study with a history of current
or past treatment for hypertension and without myocardial infarction,
stroke, cancer, or liver disease at baseline.

In analyses adjusted for potential confounders (e.g., age, smoking, diabetes),
risk of cardiovascular disease (CVD) mortality and total mortality was significantly
lower for those who drank 1–6 drinks per week (relative risk, RR, 0.6
and 0.7, respectively) and those who drank >=1
drinks per day (RR 0.6 and 0.7, respectively) than for those who rarely or
never drank.

Comments:

The authors noted
several limitations common to observational studies of alcohol consumption
and health outcomes, and also stated the limits of applying results
seen in physicians to broader primary care populations. Nonetheless,
in this cohort of physicians with hypertension who consumed low
amounts (only 3% drank >=2 drinks per day), moderate
alcohol consumption appeared to reduce risk of CVD mortality
and total mortality. Clinicians should individualize recommendations
about alcohol use and help patients determine whether the
cardiovascular benefits from moderate drinking outweigh
any potential risks.

Joseph
Conigliaro, MD, MPH

Reference:

Malinski MK, Sesso
HD, Lopez-Jimenez F, et al. Alcohol consumption and cardiovascular
disease mortality in hypertensive men. Arch Intern Med. 2004;164(6):623–628.
(view
abstract)