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(Hypertension. 2001;37:1242.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Alcohol Consumption and the Incidence of Hypertension
The Atherosclerosis Risk in Communities Study
From the Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul (F.D.F.), Brazil; the Department of Biostatistics (L.E.C.) and the Department of Epidemiology (G.H.), School of Public Health, University of North Carolina, Chapel Hill; School of Public Health and Tropical Medicine, Tulane University Medical Center (P.K.W.), New Orleans, La; and the Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health (F.J.N.), Baltimore, Md. Dr Fuchs was, at the time of preparing this manuscript, a visiting professor at the Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, Md.
Correspondence to Flávio Danni Fuchs, MD, PhD, Serviço de Cardiologia, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, 90.035-003, Porto Alegre, RS, Brazil. E-mail ffuchs{at}hcpa.ufrgs.br
Abstract—A
close relationship between alcohol consumption and hypertension has
been established, but it is unclear whether there is a threshold level
for this association. In addition, it has infrequently been studied in
longitudinal studies and in black people. In a cohort study, 8334 of
the Atherosclerosis Risk in Communities (ARIC) Study
participants, aged 45 to 64 years at baseline, who were free of
hypertension and coronary heart disease had their blood
pressures ascertained after 6 years of follow-up. Alcohol consumption
was assessed by dietary interview. The type of alcoholic beverage
predominantly consumed was defined by the source of the largest amount
of ethanol consumed. Incident hypertension was defined as a
systolic blood pressure 
140 mm Hg or
diastolic blood pressure 90 mm Hg or use of
antihypertensive medication. There was an increased risk of
hypertension in those who consumed large amounts of ethanol (210 g
per week) compared with those who did not consume alcohol over the 6
years of follow-up. The adjusted odds ratios (95% confidence interval)
were 1.2 (0.85 to 1.67) for white men, 2.02 (1.08 to 3.79) for white
women, and 2.31 (1.11 to 4.86) for black men. Only 4 black women
reported drinking >210 g ethanol per week. At low to moderate levels
of alcohol consumption (1 to 209 g per week), the adjusted odds
ratios (95% confidence interval) were 0.88 (0.71 to 1.08) in white
men, 0.89 (0.73 to 1.09) in white women, 1.71 (1.11 to 2.64) in black
men, and 0.88 (0.59 to 1.33) in black women. Systolic and
diastolic blood pressures were higher in black men who
consumed low to moderate amounts of alcohol compared with the
nonconsumers but not in the 3 other race-gender strata. Models with
polynomial terms of alcohol exposure suggested a nonlinear association
in white and black men. Higher levels of consumption of all types of
alcoholic beverages were associated with a higher risk of hypertension
for all race-gender strata. The consumption of alcohol in amounts 210
g per week is an independent risk factor for hypertension in
free-living North American populations. The consumption of low to
moderate amounts of alcohol also appears to be associated with a higher
risk of hypertension in black men.
Key Words: hypertension, alcohol-induced • risk factors • alcohol
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