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(Hypertension. 2008;51:1080.)
© 2008 American Heart Association, Inc.

Go Red Original Articles

Alcohol Consumption and the Risk of Hypertension in Women and Men

From the Divisions of Preventive Medicine (H.D.S., N.R.C., J.E.B., J.E.M., J.M.G.) and Aging (H.D.S., J.E.B., J.M.G.), Brigham and Women’s Hospital; Massachusetts Veterans Epidemiology Research and Information Center (H.D.S., J.M.G.), Veterans’ Affairs Healthcare System; Department of Epidemiology (J.E.B., J.E.M.), Harvard School of Public Health; and the Department of Ambulatory Care and Prevention (J.E.B.), Harvard Medical School, Boston, Mass.

Correspondence to Howard D. Sesso, Brigham and Women’s Hospital, 900 Commonwealth Ave East, Boston MA 02215-1204. E-mail hsesso{at}hsph.harvard.edu

Heavy alcohol intake increases the risk of hypertension, but the relationship between light-to-moderate alcohol consumption and incident hypertension remains controversial. We prospectively followed 28 848 women from the Women’s Health Study and 13 455 men from the Physicians’ Health Study free of baseline hypertension, cardiovascular disease, and cancer. Self-reported lifestyle and clinical risk factors were collected. In women, total alcohol intake was summed from liquor, red wine, white wine, and beer; men reported total alcohol intake from a single combined question. During 10.9 and 21.8 years of follow-up, 8680 women and 6012 men developed hypertension (defined as new physician diagnosis, antihypertensive treatment, reported systolic blood pressure 140 mm Hg, or diastolic blood pressure 90 mm Hg). In women, we found a J-shaped association between alcohol intake and hypertension in age- and lifestyle-adjusted models. Adding potential intermediates (body mass index, diabetes, and high cholesterol) attenuated the benefits of alcohol in the light-to-moderate range and strengthened the adverse effects of heavy alcohol intake. Beverage-specific relative risks paralleled those for total alcohol intake. In men, alcohol intake was positively and significantly associated with the risk of hypertension and persisted after multivariate adjustment. Models stratified by baseline systolic blood pressure (<120 versus 120 mm Hg) or diastolic blood pressure (<75 versus 75 mm Hg) did not alter the relative risks in women and men. In conclusion, light-to-moderate alcohol consumption decreased hypertension risk in women and increased risk in men. The threshold above which alcohol became deleterious for hypertension risk emerged at 4 drinks per day in women versus a moderate level of 1 drink per day in men.

Key Words: alcohol • hypertension • blood pressure • prospective study • men • women