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Moderate Drinking and CVD Outcomes in Hypertensive Men

This lifestyle practice was associated with reduced risk for MI — but not for other cardiovascular disease outcomes — in an observational study of hypertensive male healthcare professionals.

Moderate alcohol consumption is associated with reduced risk for death from cardiovascular disease (CVD), but some data suggest that heavy consumption is associated with increased risk for hypertension. To enhance the evidence base on alcohol consumption and CVD among people with existing hypertension and to examine MI specifically as an outcome, researchers studied 11,711 men (age range, 40–75) with baseline or incident hypertension in the prospective Health Professionals Follow-Up Study. About half were using antihypertensive medication at baseline. Alcohol consumption was assessed by questionnaire every 4 years.

Baseline data indicated that the more a man drank, the likelier he was to smoke and the less likely to have diabetes. During 16 years of follow-up, CVD outcomes differed little between nondrinkers and men who consumed 0.1 g to 4.9 g of alcohol daily. However, through five other levels of consumption (ranging from 5.0–9.9 g to 50 g per day), greater consumption was associated with lower risk for MI, of which 653 occurred during follow-up. For example, MI risk was about 30% lower among men who drank 15 g to 29.9 g of alcohol (about 1–2 drinks) per day than among nondrinkers. The level of alcohol consumption was not associated with increased or decreased risks for all-cause mortality, CVD-related mortality, or stroke. Findings were similar for drinking before diagnosis and after diagnosis of hypertension.

Comment: In this observational study of male healthcare professionals with hypertension, alcohol consumption showed no association with most CVD outcomes, but greater consumption was associated with significantly reduced risk for MI. The data should reassure hypertensive men who drink moderately that they need not change their drinking habits. However, these data should not be used to justify increasing alcohol consumption beyond moderate levels, nor do they clarify the risks and benefits of any level of drinking in hypertensive women. JNC 7 guidelines recommend limits of no more than 2 drinks per day for hypertensive men and no more than 1 drink per day for hypertensive women (JAMA 2003; 289:2560).

— Joel M. Gore, MD

Published in Journal Watch Cardiology January 2, 2007

Citation(s):

Beulens JWJ et al. Alcohol consumption and risk for coronary heart disease among men with hypertension. Ann Intern Med 2007 Jan 2; 146:10-9.

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