Interaction of alcohol and stress at the cardiovascular level

Research on the interaction of alcohol and stress on the cardiovascular system published since 1981 is reviewed. Important variables that can modify the interaction of alcohol and stress are also discussed. Consistent findings have come from studies on stress-induced tachycardia which has been shown to be decreased by alcohol ingestion. Evidence from clinical, cohort, case-control, epidemiological research indicates that long-term ingestion of alcohol is associated with lower risk of coronary heart disease. Less clear is the association of the risk of hypertension and alcohol ingestion. Primarily in women, there might be a threshold low level of alcohol consumption which is not associated with the development of hypertension. With some stressors, alcohol may depress the stressor-induced elevation of plasma catecholamines. Mechanisms believed to mediate the described alcohol-stress interaction are discussed. Existing evidence support the following mechanisms: mediation via changes in plasma lipoproteins in the case of coronary heart disease and changes in plasma calcium levels for the blood pressure effects.