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Excessive alcohol consumption and hypertension: clinical implications of current research
Peter M Miller1, Raymond F Anton, Brent M Egan
1Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 25086, USA. millerpm@musc.edu
Insights
Heavy alcohol consumption predicts hypertension. Reducing alcohol intake lowers blood pressure, and physician advice aids heavy drinkers. Routine screening for alcohol use is recommended for hypertension management.
Area of Science:
- Cardiology
- Addiction Medicine
- Public Health
Background:
- Heavy alcohol consumption (≥3 drinks/day) is linked to hypertension.
- Decreased alcohol intake significantly lowers blood pressure in a dose-dependent manner.
- Physician counseling effectively reduces heavy drinking in hypertensive individuals.
Purpose of the Study:
- To highlight the importance of evaluating alcohol consumption in hypertensive patients.
- To introduce the Alcohol Use Disorders Identification Test-C (AUDIT-C) as a screening tool.
- To discuss the role of alcohol biomarkers in monitoring heavy drinking.
Main Methods:
- Review of substantial evidence linking alcohol consumption and hypertension.
- Utilizing the Alcohol Use Disorders Identification Test-C (AUDIT-C) for screening.
- Employing alcohol biomarkers like carbohydrate-deficient transferrin for objective assessment.
Main Results:
- Heavy drinking is a predictor of hypertension.
- Alcohol reduction leads to a dose-dependent decrease in blood pressure.
- Physician advice is effective in reducing heavy drinking among hypertensive patients.
Conclusions:
- Routine assessment of alcohol consumption is crucial for hypertensive patients.
- The AUDIT-C and alcohol biomarkers aid in identifying and managing heavy drinking.
- Interventions targeting excessive alcohol use can reduce hypertension prevalence.
Abstract:
Substantial evidence demonstrates that: 1) heavy alcohol consumption (three or more standard drinks per day) is associated with and predictive of hypertension; 2) reduction in alcohol consumption is associated with a significant dose-dependent lowering of mean systolic and diastolic blood pressure; and 3) physician advice can reduce heavy drinking in hypertensive patients. These findings suggest that the routine evaluation of alcohol consumption in hypertensive patients is warranted. The Alcohol Use Disorders Identification Test-C (AUDIT-C), a brief, three-question screening test, is useful in this regard. Alcohol biomarkers can also play a role in detecting and monitoring heavy drinking in hypertensive patients whose self-reports on the AUDIT-C are suspect. Carbohydrate-deficient transferrin, a new alcohol biomarker with high specificity, can provide objective data for feedback and counseling. A routine search for excessive use of alcohol, along with brief interventions and monitoring, can have a major impact on reducing the prevalence of hypertension in the general population.
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