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Can Hypertensive Men Relax and Have a Drink?

Light-to-moderate alcohol consumption was linked with reduced mortality risk in hypertensive men.

The American Heart Association advises that patients with hypertension avoid alcoholic beverages because of a risk for blood pressure elevation. Should recent data showing that light-to-moderate alcohol consumption protects against death from cardiovascular disease (CVD) apply to hypertensive patients, given the AHA position? Researchers addressed this matter by studying data from 14,125 men in the Physicians' Health Study with histories of treatment for hypertension but without histories of MI, stroke, cancer, or liver disease. Participants reported frequency of alcohol use at baseline. Mean follow-up was 5.4 years.

At baseline, 17% of participants reported using alcohol rarely or never. Compared with this subgroup, weekly drinkers and daily drinkers showed significantly lower age- and multivariate-adjusted risks for all-cause and CVD mortality -- ranging from 27% lower to 44% lower. No such associations were found for cancer mortality. Additional adjustment for high cholesterol levels did not change the findings.

The researchers also examined whether the apparent benefit varied according to age (<60 vs. 60) and current self-reported BP (<140/90 mm Hg vs. 140/90 mm Hg). They found benefits to be consistent, regardless of age or BP.

Comment: In this analysis, light-to-moderate alcohol consumption was associated with reduced risk for all-cause and cardiovascular mortality in hypertensive men. It appears that the previously demonstrated overall CVD-prevention benefits of this behavior pattern may also apply specifically to hypertensive men. If these findings are confirmed, they suggest that hypertensive men who are light-to-moderate drinkers might be better off continuing that behavior; however, the findings should not be used as a rationale for hypertensive men to start drinking.

— Joel M. Gore, MD

Published in Journal Watch Cardiology May 7, 2004

Citation(s):

Malinski MK et al. Alcohol consumption and cardiovascular disease mortality in hypertensive men. Arch Intern Med 2004 Mar 22; 164:623-8.

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