Hypertension, Vol 20, 219-226, Copyright © 1992 by American Heart Association
Y Kawano, H Abe, S Kojima, T Ashida, K Yoshida, M Imanishi, H Yoshimi, G Kimura, M Kuramochi and T Omae
To investigate the time course of the effects of alcohol on blood pressure,
we studied the response of ambulatory blood pressure, neurohumoral
variables, and hemodynamics to a single moderate dose of alcohol in
hypertensive patients. Sixteen Japanese men (22-70 years old) with
essential hypertension who were habitual drinkers were examined under
standardized conditions. On the alcohol intake day, they ingested 1 ml/kg
ethanol (vodka) at dinner, and on the control day they consumed a
nonalcoholic beverage. The order of the two periods was randomized. Mean
ambulatory blood pressure was lower in the alcohol intake period than in
the control period (125 +/- 3/74 +/- 2 versus 132 +/- 4/78 +/- 2 mm Hg, p
less than 0.05), and the significant depressor effect of alcohol lasted for
up to 8 hours after drinking. Blood pressure on the next day did not differ
with or without alcohol intake. The acute hypotensive effect of alcohol was
associated with an increase in heart rate and cardiac output and with a
decrease in systemic vascular resistance as determined by echocardiography.
Plasma catecholamine levels and renin activity rose significantly at 2
hours after dinner, whereas vasopressin and potassium levels fell on the
alcohol day. Blood glucose and serum insulin levels were comparable between
the two periods. Three patients with marked alcohol-induced flush had
greater hypotensive and tachycardiac responses than those who did not show
an alcohol-induced flush. The change in mean blood pressure induced by
alcohol was negatively correlated with age, the baseline blood pressure,
and the change in plasma norepinephrine. These results indicate that the
major effect of acute alcohol intake is to lower blood pressure through
systemic vasodilatation in hypertensive subjects. Ambulatory blood pressure
monitoring may be useful for assessing blood pressure in habitual drinkers.
ARTICLES
Acute depressor effect of alcohol in patients with essential hypertension
Division of Hypertension and Nephrology, National Cardiovascular Center, Osaka, Japan.
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