Alcohol abuse contributes to a variety of health conditions. An area of alcohol-mediated morbidities that has received considerable attention is that of cardiovascular disease. Within this field, there is great interest in the mechanism by which alcohol consumption adversely affects blood pressure and also the threshold at which alcohol starts to cause its detrimental effects. The American Heart Association lists excessive alcohol consumption as a risk factor for hypertension in both men and women.
Background
What constitutes moderate drinking is the subject of some confusion depending on the source. The American Heart Association has established safe limits or recommendations for alcohol consumption to two standard drinks for men and one drink a day for women. Serving sizes are denoted as 12 oz. of beer, 1.5 oz. of 80 proof spirits, 1 oz. of 100 proof spirits or 4 oz. wine per day. When it comes to the specific effect of alcohol on blood pressure, however, these amounts may vary.
Amounts
A longitudinal analysis sponsored by the American Heart Association in four U.S. communities examined the relationship between high blood pressure an alcohol consumption. This work found that the risk of hypertension was increased at a threshold of greater than three drinks per day. The effects of alcohol were independent of the type of alcoholic beverage consumed. Overall, there is consensus in the field about a significant increase in blood pressure that is proportional to the quantity of alcohol consumed.
Considerations
When alcoholic beverages are consumed in moderation, they can lower the overall risk of coronary heart disease. This effect is mediated is large part through alcohol's ability to increase high density lipoprotein, or HDL cholesterol. The increase in HDL causes widening of the arterial diameter, thereby improving overall blood-flow. That being said, the beneficial effects are rapidly overcome when alcohol consumption goes above the benefit threshold.
Warnings
Drinking more than the recommended amounts for moderate consumption can cause an increase in blood levels of triglycerides. This in turn can increase blood pressure and present a risk for both gradual cardiomyopathy and cardiac arrhythmia, as well as sudden cardiac events such as stroke. Moreover, alcoholic beverages are a significant source of calories, which can lead to obesity, an independent contributor to heart disease.
Solutions
It is important to keep alcohol consumption to a minimum if there is a familial history of blood pressure or heart disease. While there are some advantages to moderate alcohol consumption, the risks far outweigh these benefits. In addition to cutting out alcohol, individuals at increased risk for hypertension can benefit from exercise and changes to dietary composition under the supervision of a physician.
References
- American Heart Association -- Alcohol, Wine and Cardiovascular Risk
- "Hypertension"; Alcohol Consumption and the Incidence of Hypertension ; The Atherosclerosis Risk in Communities Study; Fuchs et al. 2001.
- "Circulation"; The Relationships Between Alcoholic Beverage Use and Other Traits to Blood Pressure: A New Kaiser Permanente Study; Klatsky et al, 1986
- "British Medical Journal"; Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors; Rimm et al., 1999
