Evaluation of blood pressure during early alcohol withdrawal

Ninety-five patients undergoing early alcohol withdrawal were observed for a five-day period in a non-hospital facility to evaluate the natural history of blood pressure change during this period. Patients under 30 years old developed a significant increase in systolic pressure on the second abstinent day, decreasing a mean of 10 mm Hg by the fourth abstinent day. With increasing age there was a progressively smaller rise in systolic pressure. Multivariate analysis showed a history of hypertension, delirium tremens, seizures, initial pulse, race, and sex not to be predictive of blood pressure change. Diastolic pressure was unaffected. Etiology of this difference requires further study. There were no hypertensive complications in this group. Patients undergoing early withdrawal need not be treated for changes in blood pressure without evidence of end organ damage or severe hypertension.