Hypertension: a link with a high alcohol intake

A high alcohol intake promotes the development of high blood pressure, say the Swiss medical specialists review the alcoholism unit of the department of medicine in Geneva.
A harmful addiction
It is estimated that in Western countries, about 10% of the population aged over 14 years have a risk drinking or alcohol dependence.

Among the health problems associated with this drink, hypertension is often cited.

Alcohol is known to be a vasodilator but this effect is completely offset by the activation of the sympathetic nervous system occurring during a binge. This activation is due to increased production of a substance by the hypothalamus gland (located at the base of the brain) called corticotropin, which stimulates the production of catecholamines and cortisol.

In addition, alcohol has a direct effect on smooth muscle cells characterized by an addiction to the acute vasodilator effect and awareness exaggerated the vasoconstrictor effects of catecholamines, resulting in an increase in peripheral vascular resistance and arterial hypertension. Conversely, any alcohol withdrawal in a dependent person also induces abrupt changes of vital functions, including blood pressure and heart rate.

Since 1967, more than 500 studies on a number of patients ranging from 500 to 90,000 have confirmed a positive relationship between blood pressure levels and alcohol consumption.

Thus, the high prevalence of alcohol consumption in a population suffering from hypertension varies from 5 to 7% and the incidence (number of new cases per year) of alcohol-related hypertension is higher than other causes of hypertension.

In contrast, the prevalence (total number of cases per year) of hypertension in a population of alcoholic patients is much higher, between 15% and 30% depending on the study.

This positive relationship between alcohol and hypertension appears to be present in both sexes, in all races and independent of other risk factors including dietary habits.

There is also a positive relationship between the amount of alcohol consumed daily and the level of blood pressure. In fact, the risk of developing hypertension starts from 1.5 drinks per day and a dose effect could exist, with possible plateau seven or more drinks per day.

In France, the prevalence of coronary heart disease is lower, although the eating habits are similar to those of other Western European countries. This difference is linked to the tradition of drinking red wine in reality, the authors note, recent work does not allow to hold a particular type of alcohol to explain the "French paradox."

Happens - t - if it withdrawal?
The results observed on prolonged alcohol withdrawal objectify a sharp decrease in the number of hypertensive patients from D0 to D3, then gradual J5 to J10 and J18. The majority of patients with mild to moderate hypertension and only 6.3% had severe hypertension D0 against 0.7% in J18.

Three factors may explain the increase in blood pressure: the risk factor alcohol, withdrawal syndrome and age. The variability of blood pressure can also be explained by factors directly related to alcohol: deterioration of the vascular endothelium, a persistent disorder of the regulation of blood pressure all throughout the weaning and greater sensitivity to sodium (salt).

Finally, 20% of patients remain hypertensive J18. The hypothesis is that alcohol induce lasting disturbances in time, why these people should be followed throughout the course of screening for complications of hypertension, initiate medical treatment and propose an amendment to the health life.

Other vascular risk
Alcohol also increases the frequency of cerebral vascular accidents (CVA), particularly bleeding, as well as symptoms of congestive heart failure.

Hypertension which is in itself a major factor of risk of stroke, promote brain events highlighting the direct effects of alcohol on morbidity from stroke and alcoholic cardiomyopathy.

It therefore seems essential, say the authors of the article, to recommend drinkers reduce their consumption below three standard units per day, and abstinence for those who are alcohol-dependent. Similarly, to reduce the salt and fat intake and encourage physical activity and weight loss. The average effect of the reduction of alcohol consumption is 4 mmHg for systolic and 3 mmHg for diastolic.

According to the authors, before any discovery of hypertension in a patient, assess his drinking. During alcohol withdrawal of a hypertensive patient, it is also better to control in rapid blood pressure and keep in mind that the pharmacokinetics of medicinal products as hypotensive is changed during this period, they add.