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Alcohol-associated hypertension - When one drinks makes a difference

Hypertension (Impact Factor: 7.63). 01/2005; 44(6):805-6. DOI: 10.1161/01.HYP.0000146538.26193.60
Source: PubMed
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    ABSTRACT: Epidemiological, preclinical and clinical studies established the association between high alcohol consumption and hypertension. However the mechanism through which alcohol raises blood pressure remains elusive. Several possible mechanisms have been proposed such as an imbalance of the central nervous system, impairment of the baroreceptors, enhanced sympathetic activity, stimulation of the renin-angiotensin-aldosterone system, increased cortisol levels, increased vascular reactivity due to increase in intracellular calcium levels, stimulation of the endothelium to release vasoconstrictors and loss of relaxation due to inflammation and oxidative injury of the endothelium leading to inhibition of endothelium-dependent nitric oxide production. Loss of relaxation due to inflammation and oxidative injury of the endothelium by angiotensin II leading to inhibition of endothelium-dependent nitric oxide production is the major contributors of the alcohol-induced hypertension. For the prevention of alcohol-induced hypertension is to reduce the amount of alcohol intake. Physical conditioning/exercise training is one of the most important strategies to prevent/treat chronic alcohol-induced hypertension on physiological basis. The efficacious pharmacologic treatment includes the angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARBs) which have antioxidant activity and calcium channel blockers. The most effective prevention and treatment of alcohol-induced hypertension is physical exercise and the use of ACE inhibitors or ARBs in the clinic.
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    ABSTRACT: ABSTRACT Background: Alcohol use is associated with health behaviors that impact cardiovascular outcomes in patients with hypertension, including avoiding salt, exercising, weight management, and not smoking. This study examined associations between varying levels of alcohol use and self-reported cardiovascular health behaviors among hypertensive Veterans Affairs (VA) outpatients. Methods: Male outpatients with self-reported hypertension from seven VA sites who returned mailed questionnaires (n = 11,927) were divided into five levels of alcohol use: non-drinking, low-level use, and mild, moderate, and severe alcohol misuse based on AUDIT-C scores (0, 1-3, 4-5, 6-7 and 8-12, respectively). For each category, adjusted logistic regression models estimated the prevalence of patients who self-reported avoiding salt, exercising, controlling weight, or not smoking, and the composite of all four. Results: Increasing level of alcohol use was associated with decreasing prevalence of avoiding salt, controlling weight, not smoking, and the combination of all four behaviors (p-values all <0.001). A linear trend was not observed for exercise (p = 0.83), which was most common among patients with mild alcohol misuse (p = 0.01 relative to non-drinking). Conclusions: Alcohol consumption is inversely associated with adherence to cardiovascular self-care behaviors among hypertensive VA outpatients. Clinicians should be especially aware of alcohol use level among hypertensive patients.
    Substance Abuse 06/2014; 36(1). DOI:10.1080/08897077.2014.932318 · 1.62 Impact Factor
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    ABSTRACT: Background. Although there is a reported association between lifestyle factors and metabolic syndrome, very few studies have used national level data restricted to the African Americans (AAs) in the United States (US). Methods. A cross-sectional evaluation was conducted using the National Health and Nutrition Examination Survey from 1999 to 2006 including men and nonpregnant women of 20 years or older. Multiple logistic regression models were constructed to evaluate the association between lifestyle factors and metabolic syndrome. Results. AA women had a higher prevalence of metabolic syndrome (39.43%) than AA men (26.77%). After adjusting for sociodemographic factors, no significant association was found between metabolic syndrome and lifestyle factors including alcohol drinking, cigarette smoking, and physical activity. Age and marital status were significant predictors for metabolic syndrome. With increase in age, both AA men and AA women were more likely to have metabolic syndrome (AA men: OR(adj) = 1.05, 95% CI 1.04-1.06, AA women: OR(adj) = 1.06, 95% CI 1.04-1.07). Single AA women were less likely to have metabolic syndrome than married women (OR(adj) = 0.66, 95% CI 0.43-0.99). Conclusion. Lifestyle factors had no significant association with metabolic syndrome but age and marital status were strong predictors for metabolic syndrome in AAs in the US.
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