Although the relationship between alcohol and hypertension had long been suspected, it was not until 1987 when a meta-study published in the journal "Hypertension" unequivocally established that alcohol was independently linked to hypertension. This is particularly important because while risk factors such as age and sex cannot be changed, patients can modify alcohol consumption.
Dose
A 2004 study published in "Hypertension" showed that the amount of alcohol consumed is related to the risk of hypertension. For example, the risk of hypertension was more than double for people who had two or more drinks per day than those who abstained.
Not surprisingly, people who drank with meals had less risk of hypertension. This report noted that the 12 percent of research subjects who drank alcohol separately from meals had a 64 percent greater risk of hypertension. Presumably, the blood alcohol levels of those who drank without food were higher than those who drank with meals, suggesting a dose-response effect.
Alcohol Withdrawal
Various studies show that blood pressure goes down when alcohol consumption is restricted. The 2004 report in "Hypertension" suggests that alcohol restriction might be more effective than either exercise or sodium reduction in lowering blood pressure.
Biphasic Response
Curiously, the blood pressure increase found in people consuming alcohol is not immediately evident. The 2004 article in "Hypertension" cited numerous studies in which alcohol had an immediate depressor effect, meaning that blood pressure went down while drinking. The pressor effect--referring to the increase--was not evident until the next morning.
This short-term decrease in blood pressure followed by a later increase is called a biphasic response.
Types
Authors of the 2004 meta-analysis examined studies in which the beverage of choice varied from beer to wine to hard liquor. Comparing the data from these studies suggested that the type of alcoholic beverage consumed had little, if any, effect on the relative risk of hypertension. Given that wine has been reported to have a beneficial effect, the authors expressed surprise that the effect of wine was comparable to other beverages.
Recommendations
The authors of the 2004 meta-analysis suggest that the risks of alcohol can be minimized and the benefits maximized if people drink a small amount of alcohol on most days with meals. The authors noted that it was particularly gratifying that the research supported such a common-sense recommendation.
