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(Hypertension. 2009;53:4.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Alcohol Intake, Circadian Blood Pressure Variation, and Stroke

Takayoshi Ohkubo; Hirohito Metoki; Yutaka Imai

From the Departments of Planning for Drug Development and Clinical Evaluation (T.O.), Clinical Pharmacology and Therapeutics (T.O., H.M., Y.I.), and Medical Genetics (H.M.), Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan; and the Tohoku University 21st Century Center of Excellence Program "Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation" (T.O., Y.I.), Sendai, Japan.

Correspondence to Takayoshi Ohkubo, Department of Clinical Pharmacology and Therapeutics, Tohoku University Hospital, Sendai, 980-8574, Japan. E-mail tohkubo@mail.tains.tohoku.ac.jp

An extract of the first 250 words of the full text is provided, because this article has no abstract.

In this issue of Hypertension, Ohira et al¹ reported that habitual alcohol intake was positively associated with higher daytime blood pressure (BP) and a large morning BP surge based on data from 539 middle-aged Japanese men in 3 rural communities (Ikawa in the northeastern area, Noichi in the southwestern area, and Kyowa in the central area) and a southwestern urban suburb, Yao (in Osaka prefecture).

As shown in the figure by Ohira et al,¹ moderate drinkers (alcohol intake 23 to 46 g/d) and heavy drinkers (alcohol intake 46 g/d) had higher BP in the morning and during the daytime compared with nondrinkers, whereas there were no differences in BP during the 24-hour and nighttime periods among the alcohol intake groups. Because heavy alcohol intake increases the risk of stroke, especially hemorrhagic stroke, these results might indicate that a higher risk of hemorrhagic stroke in heavy drinkers is, in part, mediated by the effects of alcohol on circadian BP variation, considering previous reports that elevated morning BP and higher daytime BP levels were most closely associated with the risk of hemorrhagic stroke.^2,3

Although Ohira et al¹ excluded subjects taking antihypertensive medication, drinking habit was a significant determinant of masked "uncontrolled" hypertension diagnosed by morning home BP among treated hypertensive patients.⁴ Moreover, insufficient duration of action of antihypertensive agents, which is also a risk factor for higher morning BP,⁵ has been raised as an explanation of higher predictive power for stroke incidence of morning home BP among treated hypertensive patients.⁶ Thus, . . . [Full Text of this Article]

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