Association between daily alcohol intake and hypertension prevalence: evidence from the 2007-2018 NHANES database

Hypertension is a major public health issue globally, affecting hundreds of millions of people. Although the association between alcohol consumption and hypertension has been widely demonstrated, uncertainties remain regarding the dose-response relationship, potential confounding factors, and population-specific differences.

Data from NHANES participants aged 20 and above from 2007 to 2018 were analyzed. A weighted multivariate logistic regression model assessed the association between daily alcohol intake and hypertension prevalence, calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines (RCS) examined the potential non-linear association. Subgroup analyses evaluated interaction effects across demographic variables to identify differences in the alcohol-hypertension association among populations.

This study included 30,127 eligible participants, representing 228,198,440 individuals in the United States population after weighting. In the fully adjusted Model 3, a significant positive association was observed between daily alcohol intake and hypertension prevalence (OR: 1.007, 95% CI: 1.005-1.009; P < 0.001). Compared to the abstainers group (0 g/d), participants in the very heavy consumers group (> 40 g/d) had a significantly higher prevalence of hypertension (OR: 1.873, 95% CI: 1.585-2.213; P < 0.001). RCS analysis further confirmed the positive association between daily alcohol intake and hypertension prevalence, with no significant non-linearity detected. In the subgroup analysis, a significant interaction was detected in the racial/ethnic subgroup (P for interaction < 0.05).

A significant association exists between very heavy alcohol consumers (> 40 g/d) and an increased prevalence of hypertension. These findings underscore the importance of including alcohol intake assessments in hypertension management and prevention strategies. Further research is needed to explore the causal association between alcohol intake and hypertension and to investigate its potential biological mechanisms.