Hypertension, Vol 9, 111-121, Copyright © 1987 by American Heart Association
S MacMahon
An increased prevalence of hypertension in groups with high alcohol
consumption has been recognized for a number of years. More recently,
several studies have suggested an independent association between alcohol
consumption and blood pressure levels in samples from general populations.
Of 30 cross-sectional population studies reviewed, the majority reported
small but significant elevations in blood pressure in those consuming three
drinks or more per day in comparison with nondrinkers. In 25% of studies,
elevations in blood pressure were also reported at lower levels of
consumption; in about 40%, the blood pressure of nondrinkers was greater
than that of those consuming one to two drinks per day. In two studies, one
from the United States and one from Australia, the maximum contribution to
the prevalence of hypertension of alcohol consumption greater than two
drinks per day was estimated to be 5 to 7%; the contribution in men (11%)
was greater than that in women because of their greater alcohol
consumption. A prospective association of alcohol consumption with change
in blood pressure was observed in five studies. In a small number of
experimental studies, short-term falls in blood pressure accompanied
alcohol restriction in both normotensive and hypertensive subjects.
Uncontrolled observations in heavy drinking populations suggest that the
effect on blood pressure of alcohol withdrawal may be lasting. However,
firm conclusions about the long-term effects of alcohol restriction,
particularly in moderate consumers who represent a large proportion in many
populations, must await long-term controlled trials.
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