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Sato H, Eguchi E, Funakubo N, Nakano H, Imano H, Ohira T. Association Between Changes in Alcohol Consumption Before and After the Great East Japan Earthquake and Risk of Hypertension: A Study Using the Ministry of Health, Labour and Welfare National Database. J Epidemiol 2023; 33:607-617. [PMID: 36503902 PMCID: PMC10635811 DOI: 10.2188/jea.je20220161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/26/2022] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The 2011 Great East Japan Earthquake has resulted in a nuclear accident, forcing residents of the surrounding areas to evacuate. To determine any association between excessive drinking and hypertension in the setting of disaster, we assessed whether the proportion of excessive drinkers increased and if post-disaster excessive drinking was a risk factor for hypertension. METHODS This retrospective study assessed data from the Japanese National Database. Cumulative population data for Fukushima Prefecture (3,497,576 people) were analyzed by categorizing residents into four areas-evacuation, coastal, central, and mountainous-to calculate the proportion of excessive, heavy (equivalent to binge drinking), and at-risk drinkers for 2008-2017. The hazard ratios (HRs) for the incidence of hypertension for 2012-2017 were examined in association with changes in drinking status pre- and post-disaster, which included 136,404 people who received specific health checkups pre-disaster (2008-2010) and post-disaster (2011-2012). RESULTS The proportion of excessive drinkers among women increased after the disaster in all areas examined. The association between excessive drinking and the incidence of hypertension was determined among men and women in all areas; it was stronger among women in the evacuation areas, with the sex- and age-adjusted HRs for the incidence of hypertension of 1.41 for pre-disaster excessive drinking, 2.34 for post-disaster excessive drinking, and 3.98 for pre- and post-disaster excessive drinking, compared with not excessive drinking pre- and post-disaster. CONCLUSION Excessive drinking post-disaster may be associated with an increased risk of hypertension among men and women, especially among women in the evacuation areas.
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Affiliation(s)
- Haruka Sato
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Narumi Funakubo
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Imano
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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Attenuation by habitual alcohol drinking of the associations of obesity with blood pressure and pulse pressure. Blood Press Monit 2023; 28:17-23. [PMID: 36330757 DOI: 10.1097/mbp.0000000000000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Obesity and alcohol drinking are known to be risk factors for hypertension. However, it remains to be determined whether alcohol affects the relationships of obesity with blood pressure and pulse pressure. METHODS The participants in this study were 29 171 men who had received annual health checkups. Relationships of BMI with blood pressure and pulse pressure were investigated in four subject groups divided by average daily alcohol consumption (grams of ethanol/day), non-, light (<22), moderate (≥22 and <44) and heavy (≥44) drinkers. RESULTS BMI was significantly correlated with SBP and DBP levels both in nondrinkers and drinkers. The strength of the correlations was significantly weaker in drinkers than in nondrinkers. Odds ratios for hypertension in subjects with vs. subjects without obesity tended to be lower with an increase in alcohol intake (odds ratios with 95% confidence intervals: 4.09 (3.69-4.52) in nondrinkers; 3.11 (2.62-3.68) in light drinkers; 2.87 (2.61-3.16) in moderate drinkers; 2.81 (2.49-3.18) in heavy drinkers). Pulse pressure was weakly but significantly associated with BMI and obesity, and these associations were significantly weaker in heavy drinkers than in nondrinkers. There were significant odds ratios for hypertension and high pulse pressure of the interaction term between obesity and alcohol drinking. CONCLUSION The associations of BMI with blood pressure and pulse pressure and the associations of obesity with hypertension and high pulse pressure were weaker in drinkers than in nondrinkers. Thus, alcohol drinking attenuates the associations of obesity with hypertension and high pulse pressure.
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The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults. Br J Nutr 2021; 126:1380-1388. [PMID: 33441197 DOI: 10.1017/s0007114521000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Given the dynamic characteristic of an individual's drinking behaviours, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥ 40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5·3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the third visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2·9 mmHg, P = 0·032) and -adjusted models (3·6 mmHg, P = 0·001), and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3·9 mmHg, P = 0·003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption rather than the trajectory may be significantly related to raised SBP, and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP is adjusted in men.
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Development of the Hypertension Index Model in General Adult Using the Korea National Health and Nutritional Examination Survey and the Korean Genome and Epidemiology Study. J Pers Med 2021; 11:jpm11100968. [PMID: 34683109 PMCID: PMC8540826 DOI: 10.3390/jpm11100968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022] Open
Abstract
Hypertension, a risk factor for cardiovascular disease and all-cause mortality, has been increasing. Along with emphasizing awareness and control of hypertension, predicting the incidence of hypertension is important. Several studies have previously reported prediction models of hypertension. However, among the previous models for predicting hypertension, few models reflect various risk factors for hypertension. We constructed a sex-specific prediction model using Korean datasets, which included socioeconomic status, medical history, lifestyle-related variables, anthropometric status, and laboratory indices. We utilized the data from the Korea National Health and Nutrition Examination Survey from 2011 to 2015 to derive a hypertension prediction model. Participants aged 40 years or older. We constructed a sex-specific hypertension classification model using logistic regression and features obtained by literature review and statistical analysis. We constructed a sex-specific hypertension classification model including approximately 20 variables. We estimated its performance using the Korea National Health and Nutrition Examination Survey dataset from 2016 to 2018 (AUC = 0.847 in men, AUC = 0.901 in women). The performance of our hypertension model was considered significant based on the cumulative incidence calculated from a longitudinal dataset, the Korean Genome and Epidemiology Study dataset. We developed this hypertension prediction model using features that could be collected in a clinical office without difficulty. Individualized results may alert a person at high risk to modify unhealthy lifestyles.
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Sri Hari TY, Sree Sudha TY, Varghese AM, Krishna Sasanka KSBS, Thangaraju P. A study of risk factors and complications in elderly hypertensive subjects. J Family Med Prim Care 2021; 10:2230-2234. [PMID: 34322417 PMCID: PMC8284235 DOI: 10.4103/jfmpc.jfmpc_1959_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hypertension among the elderly is a major, highly prevalent yet treatable cardiovascular disease. AIMS & OBJECTIVES Study aims to highlight the risk factors for hypertension in the elderly in an urban setup for the benefit of improving quality of life and also reduce the incidence of the cardiovascular related complications. METHODOLOGY This is a Cross-sectional observational study. Included 125 study subjects based on selection criteria. The selected patients were subjected to a preformed and pretested schedule of questions pertaining to the risk factors. RESULTS Among the known hypertensive patients above 60 years of age, 125 subjects were included in the study. Smoking (62%), alcohol consumption (21%), family history of hypertension (26%), family history of diabetes (70%) were statistically significant risk factors observed for the development of hypertension. CONCLUSION Sedentary lifestyle (physically less active) and anthropometric measures like overweight and obesity, abnormal waist circumference, and abnormal waist hip ratio were all identified as remarkable risk for hypertension. Myocardial infarction (20%), stroke (14%), and heart failure (12%) were the chart buster complications of hypertension in the vulnerable geriatric population.
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Affiliation(s)
- TY. Sri Hari
- Senior Registrar (MICU-I), Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - TY Sree Sudha
- Senior Resident, Department of Pharmacology, AIIMS, Raipur, Chhattisgarh, India
| | - Anjaly Mary Varghese
- Assistant Professor, Department of Pharmacology, Santhiram Medical College, Nandyal, Andhra Pradesh, India
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Association between the incidence of hypertension and alcohol consumption pattern and the alcohol flushing response: A 12-year follow-up study. Alcohol 2020; 89:43-48. [PMID: 32702501 DOI: 10.1016/j.alcohol.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/24/2020] [Accepted: 07/13/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alcohol consumption is associated with hypertension, and this association depends on the alcohol consumption pattern and alcohol flushing response. In this 12-year follow-up study, we investigated the relationship between the alcohol consumption pattern and incidence of hypertension in the Korean population. METHODS We analyzed 1,366 Korean participants in the Ansung-Ansan cohort study without hypertension at baseline. The subjects were classified into four alcohol consumption patterns: never-drinking, light alcohol consumption, moderate alcohol consumption, and heavy alcohol consumption, and as flushers or non-flushers in response to alcohol. RESULTS In flushers, moderate and heavy alcohol consumption patterns increased the risk of incident hypertension compared with never-drinkers [moderate: HR 1.811 (95% CI 1.084-3.028); heavy: HR 2.494 (95% CI 1.185-5.247)], but non-flushers were not associated with increased risk of incident hypertension according to the alcohol consumption pattern. In addition, a heavy alcohol consumption pattern increased the risk of hypertension among flushers compared with non-flushers [HR 2.232 (95% CI 1.054-4.728)]. CONCLUSION In this 12-year follow-up study, we observed that moderate and heavy alcohol consumption was associated with an increased risk of hypertension in flushers. Especially, a heavy alcohol consumption pattern in flushers markedly increased the risk of hypertension.
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Liu F, Liu Y, Sun X, Yin Z, Li H, Deng K, Zhao Y, Wang B, Ren Y, Liu X, Zhang D, Chen X, Cheng C, Liu L, Liu D, Chen G, Hong S, Wang C, Zhang M, Hu D. Race- and sex-specific association between alcohol consumption and hypertension in 22 cohort studies: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2020; 30:1249-1259. [PMID: 32446870 DOI: 10.1016/j.numecd.2020.03.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/08/2020] [Accepted: 03/18/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS The alcohol-hypertension relation has been well documented, but whether women have protective effect or race and type of beverage consumed affect the association remain unclear. To quantify the relation between total or beverage-specific alcohol consumption and incident hypertension by considering the effect of sex and race. METHODS AND RESULTS Articles were identified in PubMed and Embase databases with no restriction on publication date. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random effects models. Restricted cubic splines were used to model the dose-response association. This study involved 22 articles (31 studies) and included 414,477 participants. The hypertension risk was different among liquor, wine, and beer at 5.1-10 g/d of ethanol consumption (P-across subgroups = 0.002). The hypertension risk differed between men (RR: 1.14, 95% CI: 1.07, 1.20) and women (RR: 0.98, 95% CI: 0.89, 1.06) at 10 g/d (P-across subgroups = 0.005). We found a linear alcohol-hypertension association among white (P-linearity = 0.017), black people (P-linearity = 0.035), and Asians (P-linearity<0.001). With 10 g/d increment of consumption, the RRs for hypertension were 1.06 (95% CI: 1.04, 1.08), 1.14 (95% CI: 1.01, 1.28), and 1.06 (95% CI: 1.01, 1.10) for Asians, black, and white people, respectively. CONCLUSION Sex modifies the alcohol-hypertension association at low level of alcohol consumption and we did not find evidence of a protective effect of alcohol consumption among women. Black people may have higher hypertension risk than Asians and white people at the same ethanol consumption.
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Affiliation(s)
- Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Zhaoxia Yin
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Xuejiao Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongdong Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xu Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Cheng Cheng
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Leilei Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dechen Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Guozhen Chen
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Shihao Hong
- Department of Clinical Medicine, Shenzhen University, Shenzhen, Guangdong, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; The Third Affiliated Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Guangdong Key Laboratory for Genome Stability & Disease Prevention, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
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Jung MH, Shin ES, Ihm SH, Jung JG, Lee HY, Kim CH. The effect of alcohol dose on the development of hypertension in Asian and Western men: systematic review and meta-analysis. Korean J Intern Med 2020; 35:906-916. [PMID: 31795024 PMCID: PMC7373951 DOI: 10.3904/kjim.2019.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/08/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/AIMS There are inconsistencies in the effects of low to moderate dose alcohol consumption on the development of hypertension in adult men. We hypothesized that a region-specific effect might participate in this heterogeneity. METHODS We conducted a systematic review and meta-analysis to evaluate the effect of alcohol dose on hypertension incidence using contemporary data through December 2017. Subjects were categorized according to their level of alcohol consumption as non-drinkers (reference) and low- (0.01 to 20.0 g/day), moderate- (20.1 to 40.0 g/day), moderate- to high- (40.1 to 60.0 g/day), and high-dose (> 60.0 g/day) drinkers. We defined hypertension as a blood pressure ≥ 140/90 mmHg and/or the use of anti-hypertensive drugs. RESULTS In total, 11 articles (seven Asian and four Western) were selected for our analysis. Among Asian men, a significantly elevated risk was observed even in the low alcohol dose group in comparison with the group with no alcohol consumption, and the risk increased in a dose-dependent manner (pooled relative risks [95% confidence intervals (CI)]: 1.25 [1.13 to 1.38], 1.48 [1.27 to 1.72], 1.75 [1.43 to 2.15], and 1.78 [1.51 to 2.09]). Among Western men, a similar dose-response relationship was noted in general (p for subgroup difference > 0.1), but a significantly elevated risk was evident only in the high-dose group (pooled relative risks [95% CI]: 1.22 [0.85 to 1.74], 1.57 [0.90 to 2.75], 1.47 [0.44 to 4.91], and 1.49 [1.02 to 2.18]). CONCLUSION Even low doses of alcohol can lead to the development of hypertension, particularly in Asian men. Our findings could serve as additional evidence for developing an appropriate preventive strategy in each region.
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Affiliation(s)
- Mi-Hyang Jung
- Cardiovascular Center, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Ein-Soon Shin
- Research Agency for Clinical Practice Guidelines, KAMS Research Center, Korean Academy of Medical Sciences, Seoul, Korea
| | - Sang-Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Sang-Hyun Ihm, M.D. Division of Cardiology, Department of Internal Medicine, College of Medicine, Bucheon St. Mary’s Hospital, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea Tel: +82-32-340-7027, Fax: +82-32-340-2669, E-mail:
| | - Jin-Gyu Jung
- Department of Family Medicine, Research Institute for Medical Sciences, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Alcohol consumption and risks of hypertension and cardiovascular disease in Japanese men and women. Hypertens Res 2020; 43:477-481. [PMID: 32203447 DOI: 10.1038/s41440-020-0417-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/08/2022]
Abstract
This article focuses on selected large prospective cohort studies that examined the effect of alcohol consumption on the risks of hypertension and cardiovascular disease in Japanese men and women. Regardless of age and sex, alcohol consumption was positively associated with an increased risk of hypertension. There was a J-shaped association between alcohol consumption and the risks of stroke and cardiovascular disease in Japanese men, which was consistent with the findings of the studies conducted by Western countries. Few studies have been conducted to examine the effect of alcohol consumption on the risks of stroke and coronary heart disease in Asian women. We first showed that heavy alcohol consumption of ≥300 g ethanol/week was associated with increased risk of total stroke, hemorrhagic stroke, intraparenchymal hemorrhage, subarachnoid hemorrhage and ischemic stroke in women while light drinking was not associated with a reduced risk of stroke. Furthemore, heavy drinking (≥46.0 g ethanol/day) had an increased risk of mortality from coronary heart disease in women, whereas light drinking (0.1-22.9 g ethanol/day) had a reduced risk of mortality from total cardiovascular disease. The association between alcohol consumption and the risk of stroke was modified by social support and salt preference.
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Body mass index modifies the association between frequency of alcohol consumption and incidence of hypertension in men but not in women: a retrospective cohort study. Hypertens Res 2020; 43:322-330. [PMID: 31913352 DOI: 10.1038/s41440-019-0382-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/08/2022]
Abstract
Alcohol consumption is one of the major modifiable risk factors of hypertension. The aim of the present retrospective study was to assess the clinical impact of obesity on the association between alcohol consumption and the incidence of hypertension. The present study included 5116 male and 6077 female university employees with a median age of 32 (interquartile range 27-39) who underwent annual health checkups between January 2005 and March 2013. Self-reported drinking frequency was recorded at their first checkup and categorized into rarely and 1-3, 4-6, and 7 days/week. During the median observational period of 4.9 years (interquartile range 2.1-8.3), hypertension, defined as systolic/diastolic blood pressure of ≥140/90 mmHg and/or self-reported treatment for hypertension, was observed in 1067 (20.9%) men and 384 (6.3%) women. Poisson regression models adjusted for clinically relevant factors revealed a dose-dependent association between drinking frequency and the incidence of hypertension in men (adjusted incidence rate ratio [95% confidence interval] of men who drank rarely, 1-3, 4-6, and 7 days/week was 1.00 [reference], 1.12 [0.97-1.30], 1.42 [1.19-1.70], and 1.35 [1.14-1.59], respectively; Ptrend < 0.001). However, this association was not observed in women. The dose-dependent association was significant in nonobese men (body mass index (BMI) < 25 kg/m2), but not in obese men (BMI ≥25 kg/m2) (P for interaction between drinking frequency and BMI = 0.072). The present study provides clinically useful evidence to identify the drinkers who may reap the health benefits of abstinence from alcohol consumption.
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Roerecke M, Tobe SW, Kaczorowski J, Bacon SL, Vafaei A, Hasan OSM, Krishnan RJ, Raifu AO, Rehm J. Sex-Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies. J Am Heart Assoc 2018; 7:e008202. [PMID: 29950485 PMCID: PMC6064910 DOI: 10.1161/jaha.117.008202] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/13/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear. METHODS AND RESULTS We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of hypertension in people without hypertension. Random-effects meta-analyses and metaregressions were conducted. Data from 20 articles with 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were included. In people drinking 1 to 2 drinks/day (12 g of pure ethanol per drink), incidence of hypertension differed between men and women (relative riskwomen vs men=0.79; 95% confidence interval, 0.67-0.93). In men, the risk for hypertension in comparison with abstainers was relative risk=1.19 (1.07-1.31; I2=59%), 1.51 (1.30-1.76), and 1.74 (1.35-2.24) for consumption of 1 to 2, 3 to 4, and 5 or more standard drinks per day, respectively. In women, there was no increased risk for 1 to 2 drinks/day (relative risk=0.94; 0.88-1.01; I2=73%), and an increased risk for consumption beyond this level (relative risk=1.42; 1.22-1.66). CONCLUSIONS Any alcohol consumption was associated with an increase in the risk for hypertension in men. In women, there was no risk increase for consumption of 1 to 2 drinks/day and an increased risk for higher consumption levels. We did not find evidence for a protective effect of alcohol consumption in women, contrary to earlier meta-analyses.
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Affiliation(s)
- Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Dalla Lana School of Public Health (DLSPH), University of Toronto, Ontario, Canada
- PAHO/WHO Collaborating Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sheldon W Tobe
- Department of Medicine, University of Toronto, Ontario, Canada
- Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, Université de Montréal, Quebec, Canada
- CRCHUM (University of Montreal Hospital Research Centre), Montreal, Quebec, Canada
| | - Simon L Bacon
- Department of Exercise Science, Concordia University, Montreal, Quebec, Canada
- Montreal Behavioural Medicine Centre, CIUSSS-NIM, Montreal, Quebec, Canada
| | - Afshin Vafaei
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Omer S M Hasan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Dalla Lana School of Public Health (DLSPH), University of Toronto, Ontario, Canada
| | - Rohin J Krishnan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Amidu O Raifu
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Dalla Lana School of Public Health (DLSPH), University of Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
- PAHO/WHO Collaborating Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
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12
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Gilbert-Ouimet M, Ma H, Glazier R, Brisson C, Mustard C, Smith PM. Adverse effect of long work hours on incident diabetes in 7065 Ontario workers followed for 12 years. BMJ Open Diabetes Res Care 2018; 6:e000496. [PMID: 30002856 PMCID: PMC6038836 DOI: 10.1136/bmjdrc-2017-000496] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/30/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE According to the International Diabetes Federation, the most important challenge for prevention is now to identify social and environmental modifiable risk factors of diabetes. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. We evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada. RESEARCH DESIGN AND METHODS Data from Ontario respondents (35-74 years of age) to the 2003 Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample consisted of actively employed participants with no previous diagnoses of diabetes. Cox proportional hazard regression models were then performed to evaluate the relationship between long work hours (≥45 hours per week) and the incidence of diabetes. RESULTS Long work hours did not increase the risk of developing diabetes among men. However, among women, those usually working 45 hours or more per week had a significantly higher risk of diabetes than women working between 35 and 40 hours per week (HR: 1.63 (95% CI 1.04 to 2.57)). The effect was slightly attenuated when adjusted for the potentially mediating factors which are smoking, leisure time physical activity, alcohol consumption and body mass index. CONCLUSION Working 45 hours or more per week was associated with an increased incidence of diabetes among women, but not men. Identifying modifiable risk factors such as long work hours is of major importance to improve prevention strategies and orient policy making.
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Affiliation(s)
- Mahée Gilbert-Ouimet
- Axe santé des populations et pratiques optimales en santé, Centre de recherche FRQS du CHU de Québec, Québec, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Huiting Ma
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Rick Glazier
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto and St Michael’s Hospital, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Chantal Brisson
- Axe santé des populations et pratiques optimales en santé, Centre de recherche FRQS du CHU de Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Canada
| | - Cameron Mustard
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter M Smith
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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13
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Associations of Fatty Liver Disease with Hypertension, Diabetes, and Dyslipidemia: Comparison between Alcoholic and Nonalcoholic Steatohepatitis. Gastroenterol Res Pract 2017; 2017:9127847. [PMID: 28912806 PMCID: PMC5585648 DOI: 10.1155/2017/9127847] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/05/2017] [Accepted: 08/15/2017] [Indexed: 12/19/2022] Open
Abstract
Alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH) are representative types of fatty liver disease (FLD) and have similar histologic features. In this study, we aimed to compare the associations of the two FLD types with hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DL). A nationwide survey investigating FLD status included 753 Japanese subjects (median age 55 years; male 440, female 313) with biopsy-proven ASH (n = 172) or NASH (n = 581). We performed a multiple logistic regression analysis to identify the factors associated with HT, DM, or DL. Older age and a higher body mass index were significant factors associated with HT. Older age, female sex, a higher body mass index, advanced liver fibrosis, and the NASH type of FLD (odds ratio 2.77; 95% confidence interval 1.78–4.31; P < 0.0001) were significant factors associated with DM. Finally, the NASH type of FLD (odds ratio 4.05; 95% confidence interval 2.63–6.24; P < 0.0001) was the only significant factor associated with DL. Thus, the associations of NASH with DM and DL were stronger than those of ASH with DM and DL. In the management of FLD subjects, controlling DM and DL is particularly important for NASH subjects.
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14
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Seki S, Oki Y, Tsunoda S, Takemoto T, Koyama T, Yoshimura M. Impact of alcohol intake on the relationships of uric acid with blood pressure and cardiac hypertrophy in essential hypertension. J Cardiol 2016; 68:447-454. [DOI: 10.1016/j.jjcc.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/29/2015] [Accepted: 11/05/2015] [Indexed: 12/26/2022]
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Tanaka A, Cui R, Kitamura A, Liu K, Imano H, Yamagishi K, Kiyama M, Okada T, Iso H. Heavy Alcohol Consumption is Associated with Impaired Endothelial Function. J Atheroscler Thromb 2016; 23:1047-54. [PMID: 27025680 PMCID: PMC5090811 DOI: 10.5551/jat.31641] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Aim: Previous studies have reported that moderate alcohol consumption is protective against cardiovascular disease, but heavy alcohol consumption increases its risk. Endothelial dysfunction is hypothesized to contribute to the development of atherosclerosis and cardiovascular disease. However, few population-based studies have examined a potential effect of alcohol consumption on endothelial function. Methods: This study included 404 men aged 30–79 years who were recruited from residents in 2 communities under the Circulatory Risk in Communities Study in 2013 and 2014. We asked the individuals about the frequency and volume of alcohol beverages and converted the data into grams of ethanol per day. Endothelial function was assessed by brachial artery flow-mediated dilation (FMD) measurements during reactive hyperemia. We performed cross-sectional analysis of alcohol consumption and %FMD by logistic regression analysis, adjusting for age, baseline brachial artery diameter, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, HbA1c, smoking, antihypertensive medication use, and community. Results: Individuals who drank ≥ 46 g/day ethanol had a lower age-adjusted mean %FMD than non-drinkers (p<0.01). Compared with non-drinkers, the age-adjusted odds ratios (ORs) (95% confidence interval) of low %FMD (<5.3%) for former, light (<23.0 g/day ethanol), moderate (23.0–45.9 g/day ethanol), and heavy (≥ 46.0 g/day ethanol) drinkers were 1.61 (0.67–3.89), 0.84 (0.43–1.66), 1.09 (0.52–2.25), and 2.99 (1.56–5.70), respectively. The corresponding multivariable-adjusted ORs were 1.76 (0.69–4.50), 0.86 (0.42–1.76), 0.98 (0.45–2.12), and 2.39 (1.15–4.95), respectively. Conclusions: Heavy alcohol consumption may be an independent risk factor of endothelial dysfunction in Japanese men.
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Affiliation(s)
- Aoi Tanaka
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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16
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Wakabayashi M, McKetin R, Banwell C, Yiengprugsawan V, Kelly M, Seubsman SA, Iso H, Sleigh A. Alcohol consumption patterns in Thailand and their relationship with non-communicable disease. BMC Public Health 2015; 15:1297. [PMID: 26704520 PMCID: PMC4690366 DOI: 10.1186/s12889-015-2662-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 12/21/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Heavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries. We report on the relationship between alcohol consumption and NCDs in Thailand. METHODS A nationwide cross sectional survey was conducted of 87,151 Thai adult open university students aged 15 to 87 years (mean age 30.5 years) who were recruited into the Thai Cohort Study. Participants were categorized as never having drunk alcohol (n = 22,527), as being occasional drinkers who drank infrequently but heavily (4+ glasses/occasion - occasional heavy drinkers, n = 24,152) or drank infrequently and less heavily (<4 glasses/occasion - occasional light drinkers, n = 26,861). Current regular drinkers were subdivided into those who either drank heavily (4 + glasses per occasion - regular heavy drinkers, n = 3,675) or those who drank less (<4 glasses/occasion -regular light drinkers, n = 490). There were 7,548 ex-drinkers in the study. Outcomes were lifetime diagnoses of self-reported NCDs and obesity (body mass index ≥ 25). RESULTS Most women were never drinkers (40 % among females) or occasional light drinkers (39 %), in contrast to men (11 % and 22 %, respectively). Alcohol consumption was associated with urban in-migration and other recognized risks for NCDs (sedentary lifestyle and poor diet). After adjustment for these factors the odds ratios (ORs) for several NCDs outcomes - high cholesterol, hypertension, and liver disease - were significantly elevated among both occasional heavy drinkers (1.2 to 1.5) and regular heavy drinkers (1.5 to 2.0) relative to never drinkers. CONCLUSIONS Heavy alcohol consumption of 4 or more glasses per occasion, even if the occasions were infrequent, was associated with elevated risk of NCDs in Thailand. These results highlight the need for strategies in Thailand to reduce the quantity of alcohol consumed to prevent alcohol-related disease. Thailand is fortunate that most of the female population is culturally protected from drinking and this national public good should be endorsed and supported.
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Affiliation(s)
- Mami Wakabayashi
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.
| | - Rebecca McKetin
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sam-ang Seubsman
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
- School of Human Ecology, The Sukhothai Thammathirat Open University, Bankgok, Nonthaburi, Thailand
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Adrian Sleigh
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
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17
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Yang HK, Han K, Park YM, Kwon HS, Yoon KH, Lee SH. Different effect of alcohol consumption on hypertension according to metabolic health status. J Hum Hypertens 2015; 30:591-8. [DOI: 10.1038/jhh.2015.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/09/2015] [Accepted: 08/14/2015] [Indexed: 01/22/2023]
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18
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Van Bui T, Blizzard CL, Luong KN, Van Truong NL, Tran BQ, Otahal P, Srikanth V, Nelson MR, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Gall S. Alcohol Consumption in Vietnam, and the Use of 'Standard Drinks' to Measure Alcohol Intake. Alcohol Alcohol 2015; 51:186-95. [PMID: 26884509 DOI: 10.1093/alcalc/agv082] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 06/18/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS To provide nationally representative data on alcohol consumption in Vietnam and to assess whether reported numbers of 'standard drinks' consumed have evidence of validity (particularly in rural areas where home-made alcohol is consumed from cups of varying size). METHODS A nationally representative population-based survey of 14,706 participants (46.5% males, response proportion 64.1%) aged 25-64 years in Vietnam. Measurements were made in accordance with WHO STEPS protocols. Data were analysed using complex survey methods. RESULTS Among men, 80% reported drinking alcohol during the last year, and 40% were hazardous/harmful drinkers. Approximately 60% of men and <5% of women had consumed alcohol during the last week, with one-in-four of the men reporting having consumed at least five standard drinks on at least one occasion. Numbers of standard drinks reported by men were associated with blood pressure/hypertension, particularly in rural areas (P < 0.001 for trend). Most of the calibration and discrimination possible from self-reported information on alcohol consumption was provided by binary responses to questions on whether or not alcohol had been consumed during the reference period. CONCLUSION Alcohol use and harmful consumption were common among Vietnamese men but less pronounced than in Western nations. Self-reports of quantity of alcohol consumed in terms of standard drinks had predictive validity for blood pressure and hypertension even in rural areas. However, using detailed measures of consumption resulted in only minor improvements in prediction compared to simple measures.
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Affiliation(s)
- Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - C Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Nakamura K, Okuda N, Okamura T, Miura K, Nishimura K, Yasumura S, Sakata K, Hidaka H, Okayama A. Alcohol consumption, hospitalization and medical expenditure: a large epidemiological study on the medical insurance system in Japan. Alcohol Alcohol 2014; 50:236-43. [PMID: 25520181 DOI: 10.1093/alcalc/agu089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS This study investigated the relationship between alcohol drinking habits and the onset of high medical expenditure in a Japanese male population. METHODS The cohort comprised 94,307 male beneficiaries 40-69 years of age of the Japanese medical insurance system, who had daily alcohol drinking habits. The likelihood of incurring high medical expenditure, defined as the ≥90th percentile of the medical expenditure distribution in the study population 1 year after baseline, as well as the likelihood of undergoing hospitalization that year were compared among the participants grouped according to their alcohol consumption amount (<2, 2-3.9, 4-5.9, ≥6 drinks/day). RESULTS Participants who ranked in the top 10% medical expenditure group within the 1 year after baseline each incurred at least 2152 euros/year. The top 10% medical expenditure group accounted for 61.1% of the total medical expenditure in the study population. The odds ratios (95% confidence intervals) for ranking in the top 10% group during the 1-year period, compared with the <2 drinks (23 g of alcohol)/day group, were 1.08 (1.02-1.15) for 2-3.9 drinks/day, 1.11 (1.05-1.19) for 4-5.9 drinks/day, and 1.31 (1.18-1.45) for ≥6 drinks/day after adjustment for age, body mass index, and smoking and exercise habits. The adjusted odds ratios for undergoing hospitalization were 1.11 (1.04-1.19), 1.14 (1.06-1.24) and 1.39 (1.24-1.56), respectively. CONCLUSION The likelihood of incurring high medical expenditure and undergoing hospitalization increased with daily alcohol consumption amount.
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Affiliation(s)
- Koshi Nakamura
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Katsuyuki Miura
- Department of Public Health, and Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Kunihiro Nishimura
- Department of Evidence Based Medicine and Risk Analysis, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Yahaba, Japan
| | - Hideki Hidaka
- Medical and Health Care Center, Sanyo Electric Group Health Insurance Association, Moriguchi, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
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Jaubert MP, Jin Z, Russo C, Schwartz JE, Homma S, Elkind MSV, Rundek T, Sacco RL, Di Tullio MR. Alcohol consumption and ambulatory blood pressure: a community-based study in an elderly cohort. Am J Hypertens 2014; 27:688-94. [PMID: 24363276 DOI: 10.1093/ajh/hpt235] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although heavy alcohol consumption is associated with hypertension, the impact of lighter consumption on blood pressure (BP) is controversial. The protective effect of light alcohol consumption on cardiovascular disease described in previous studies could be, in part, mediated by effects of alcohol on BP. However, only a few studies investigating the association between alcohol and BP included elderly subjects, despite their higher risk of hypertension sequelae. Accordingly, we evaluated the relationship between alcohol consumption and 24-hour ambulatory BP in a community-based elderly cohort. METHODS Among the participants in the Cardiac Abnormalities and Brain Lesion study, 553 subjects (mean age = 70.6 ± 9.6 years) who underwent 24-hour ambulatory BP monitoring were examined. Alcohol consumption was categorized as (i) none (reference; <1 drink/month); (ii) very light consumption (1 drink/month to 1 drink/week); (iii) light consumption (2 drinks/week to 1 drink/day); (iv) moderate-to-heavy consumption (>1 drink/day). Former drinkers were excluded. RESULTS After adjustment for relevant covariables, mean values of daytime diastolic BP (DBP), nighttime DBP, and 24-hour DBP were significantly higher in moderate-to-heavy drinkers than in the reference group, whereas systolic BP parameters were not significantly different across consumption groups. Daytime systolic BP and DBP variability (SD of the measurements) were significantly lower in very light drinkers than in the reference group, independent of potential confounders. CONCLUSIONS Moderate-to-heavy alcohol consumption was associated with higher DBP values. Very light alcohol consumption was associated with reduced daytime BP variability. The latter association may contribute to the known beneficial cardiovascular effects of light alcohol consumption.
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Jung JG, Kim JS, Kim YS, Oh MK, Yoon SJ. Hypertension Associated with Alcohol Consumption Based on the Facial Flushing Reaction to Drinking. Alcohol Clin Exp Res 2013; 38:1020-5. [PMID: 24256516 DOI: 10.1111/acer.12302] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Jin-Gyu Jung
- Department of Family Medicine; Research Institute for Medical Sciences; School of Medicine; Chungnam National University; Daejeon Korea
| | - Jong-Sung Kim
- Department of Family Medicine; Research Institute for Medical Sciences; School of Medicine; Chungnam National University; Daejeon Korea
| | - Young-Seok Kim
- Department of Family Medicine; Research Institute for Medical Sciences; School of Medicine; Chungnam National University; Daejeon Korea
| | - Mi-Kyeong Oh
- Departments of Family Medicine; College of Medicine; University of Ulsan; Gangneung Asan Hospital; Gangneung Korea
| | - Seok-Joon Yoon
- Department of Family Medicine; Research Institute for Medical Sciences; School of Medicine; Chungnam National University; Daejeon Korea
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22
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Okubo Y, Sairenchi T, Irie F, Yamagishi K, Iso H, Watanabe H, Muto T, Tanaka K, Ota H. Association of alcohol consumption with incident hypertension among middle-aged and older Japanese population: the Ibarakai Prefectural Health Study (IPHS). Hypertension 2013; 63:41-7. [PMID: 24126168 DOI: 10.1161/hypertensionaha.113.01585] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to examine the effect of age on the relationship between alcohol consumption and incident hypertension in a general Japanese population. A cohort of Japanese men (n=37 310) and women (n=78 426) aged 40 to 79 years who underwent community-based health checkups from 1993 to 2004 and were free of hypertension were followed up with annual examinations, including the measurement of blood pressure, until the end of 2010. Incident hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or the initiation of treatment for hypertension. Hazard ratios for incident hypertension according to alcohol consumption were estimated using a Cox proportional hazards model adjusted for possible confounding variables. A total of 45 428 participants (39.3%) developed hypertension (16 155 men and 29 273 women) for a mean follow-up time of 3.9 (1-18) years. Significant associations between alcohol consumption and incident hypertension were found in both sexes and age groups (P for trend was <0.001 for men aged 40-59 years and aged 60-79 years; 0.004 for women aged 40-59 years and 0.026 for women aged 60-79 years). No significant interaction with age on the association of alcohol consumption with incident hypertension was found in either sex (P for interaction, >0.05). Our results suggest that alcohol consumption is a similar risk factor for incident hypertension in both the middle-aged and the older populations.
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Affiliation(s)
- Yoshiro Okubo
- Department of Public Health, Dokkyo Medical University School of Medicine, 880 Kita-kobasyashi, Shimotugagun-Mibu, Tochigi 321-0293, Japan.
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Thawornchaisit P, de Looze F, Reid CM, Seubsman SA, Sleigh AC. Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students. BMJ Open 2013; 3:e002826. [PMID: 23801711 PMCID: PMC3696868 DOI: 10.1136/bmjopen-2013-002826] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period. DESIGN A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 2009. SETTING As Thailand is transitioning from a developing to a middle-income developed country, chronic diseases (particularly cardiovascular disease) have emerged as major health issues. Hypertension is a major risk factor for heart attack and stroke and cross-sectional studies have indicated that the prevalence is increasing. STUDY PARTICIPANTS A total of 57 558 Sukhothai Thammathirat Open University students who participated in both the 2005 and 2009 questionnaire surveys and who were normotensive in 2005 were included in the analysis. MEASURES Adjusted relative risks associating each risk factor and incidence of hypertension by sex, after controlling for confounders such as age, socioeconomic status, body mass index (BMI) and underlying diseases. RESULTS The overall 4-year incidence of hypertension was 3.5%, with the rate in men being remarkably higher than that in women (5.2% vs 2.1%). In both sexes, hypertension was associated with age, higher BMI and comorbidities but not with income and education. In men, hypertension was associated with physical inactivity, smoking, alcohol and fast food intake. In women, hypertension was related to having a partner. CONCLUSIONS In both men and women, hypertension was strongly associated with age, obesity and comorbidities while it had no association with socioeconomic factors. The cohort patterns of socioeconomy and hypertension reflect that the health risk transition in Thais is likely to be at the middle stage. Diet and lifestyle factors associate with incidence of hypertension in Thais and may be amenable targets for hypertension control programmes.
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Affiliation(s)
- Prasutr Thawornchaisit
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ferdinandus de Looze
- Faculty of Health Sciences, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
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Nguyen H, Odelola OA, Rangaswami J, Amanullah A. A review of nutritional factors in hypertension management. Int J Hypertens 2013; 2013:698940. [PMID: 23691281 PMCID: PMC3649175 DOI: 10.1155/2013/698940] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/15/2013] [Indexed: 12/18/2022] Open
Abstract
Hypertension is a major health problem worldwide. Its attendant morbidity and mortality complications have a great impact on patient's quality of life and survival. Optimizing blood pressure control has been shown to improve overall health outcomes. In addition to pharmacological therapies, nonpharmacological approach such as dietary modification plays an important role in controlling blood pressure. Many dietary components such as sodium, potassium, calcium, and magnesium have been studied substantially in the past decades. While some of these nutrients have clear evidence for their recommendation, some remain controversial and are still of ongoing study. Dietary modification is often discussed with patients and can provide a great benefit in blood pressure regulation. As such, reviewing the current evidence will be very useful in guiding patients and their physician and/or dietician in decision making. In this review article of nutritional factors in hypertension management, we aim to examine the role of nutritional factors individually and as components of whole dietary patterns.
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Affiliation(s)
- Ha Nguyen
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Olaide A. Odelola
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Janani Rangaswami
- Department of Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Aman Amanullah
- Noninvasive Cardiology, Albert Einstein Medical Center, Clinical Professor of Medicine, Jefferson Medical College of Thomas Jefferson University, 5501 Old York Road, HB-3, Philadelphia, PA 19141, USA
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Toshikuni N, Fukumura A, Hayashi N, Nomura T, Tsuchishima M, Arisawa T, Tsutsumi M. Comparison of the relationships of alcoholic and nonalcoholic fatty liver with hypertension, diabetes mellitus, and dyslipidemia. J Clin Biochem Nutr 2012; 52:82-8. [PMID: 23341703 PMCID: PMC3541424 DOI: 10.3164/jcbn.12-55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 06/20/2012] [Indexed: 12/14/2022] Open
Abstract
We compared the relationships of alcoholic fatty liver and nonalcoholic fatty liver with hypertension, diabetes mellitus, and dyslipidemia. Using a nationwide Japanese survey, we collected data on subjects with biopsy-proven alcoholic fatty liver or nonalcoholic fatty liver. Multiple logistic regression analysis was performed to determine whether alcoholic fatty liver and nonalcoholic fatty liver are associated factors for these diseases. Data on 191 subjects (65, alcoholic fatty liver; 126, nonalcoholic fatty liver) were analyzed. Alcoholic fatty liver (odds ratio, 2.54; 95% confidence interval, 1.06–6.32; p = 0.040), age ≥55 years, and body mass index ≥25 kg/m2 were correlated with hypertension, whereas nonalcoholic fatty liver (odds ratio, 2.32; 95% confidence interval, 1.08–5.20; p = 0.035) and serum γ-glutamyl transpeptidase levels ≥75 IU/l were correlated with dyslipidemia. Furthermore, we found that there were biological interactions between alcoholic fatty liver and body mass index ≥25 kg/m2 in ≥55-year-old subjects (attributable proportion due to interaction, 0.68; 95% confidence interval, 0.19–1.17), as well as between alcoholic fatty liver and age ≥55 years in subjects with body mass index ≥25 kg/m2 (attributable proportion due to interaction, 0.71; 95% confidence interval, 0.24–1.18). Alcoholic fatty liver was more strongly associated with hypertension than nonalcoholic fatty liver and nonalcoholic fatty liver was more strongly associated with dyslipidemia than alcoholic fatty liver. Moreover, alcoholic fatty liver, obesity, and older age may interact to influence hypertension status.
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Affiliation(s)
- Nobuyuki Toshikuni
- Department of Gastroenterology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
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Satoh H, Nishihira J, Wada T, Fujii S, Tsutui H. The relation between habitual sleep duration and blood pressure values in Japanese male subjects. Environ Health Prev Med 2012; 18:215-20. [PMID: 23086669 DOI: 10.1007/s12199-012-0309-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 09/30/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated that sleep duration is closely associated with metabolic risk factors. However, the relationship between habitual sleep duration and blood pressure values in Japanese population has not been fully established. METHODS We performed a cross-sectional study of 1,670 Japanese male subjects to clarify the relationship between habitual sleep duration and blood pressure values. The study subjects were divided into four groups (<6, 6-, 7-, and ≥8 h) according to their nightly habitual sleep duration. RESULTS The rate of subjects with <6, 6-, 7-, and ≥8 h sleep duration was 12.0, 37.6, 38.2, and 12.2 %, respectively. Compared with the group with 7-h sleep duration (referent), the <6 and ≥8 h groups had significantly greater systolic and diastolic blood pressure values. The rate of hypertensive subjects, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, with sleep duration of <6, 6-, 7-, and ≥8 h was 13.4, 5.7, 7.5, and 13.8 %, respectively. Compared with the group with 7-h sleep duration (referent), the multivariate odds ratios (95 % confidence interval) of the groups with <6 and ≥8 h for hypertension was 2.43 (1.40-4.20, P < 0.01) and 2.28 (1.31-3.95, P < 0.01), respectively, adjusted for conventional cardiovascular risk factors. CONCLUSION The present study demonstrates that both long and short habitual sleep duration were significantly associated with high blood pressure values and hypertension occurrence in Japanese male subjects.
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Affiliation(s)
- Hiroki Satoh
- Department of Clinical Management and Informatics, Hokkaido Information University, 59-2 Nishi-Nopporo, Ebetsu, Hokkaido 069-8585, Japan.
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Briasoulis A, Agarwal V, Messerli FH. Alcohol Consumption and the Risk of Hypertension in Men and Women: A Systematic Review and Meta-Analysis. J Clin Hypertens (Greenwich) 2012; 14:792-8. [DOI: 10.1111/jch.12008] [Citation(s) in RCA: 217] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Guo X, Zhang X, Li Y, Zhou X, Yang H, Ma H, Wang N, Liu J, Zheng L, Sun Y. Differences in healthy lifestyles between prehypertensive and normotensive children and adolescents in Northern China. Pediatr Cardiol 2012; 33:222-8. [PMID: 21915719 DOI: 10.1007/s00246-011-0112-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 08/22/2011] [Indexed: 01/30/2023]
Abstract
BACKGROUND This study aimed to evaluate the prevalence and differences of healthy lifestyles among children and adolescents differing in blood pressure status. METHODS A cross-sectional study analyzed 5,270 children and adolescents ages 5-18 years. Anthropometric measurements and information on six healthy lifestyles (normal body mass index [BMI], appropriate physical activity, sufficient sleep, appropriate breakfast, no smoking, and no alcohol use) were collected by well-trained personnel. RESULTS The prevalence of healthy lifestyles was relatively low. Only 22.4% of the study participants had all six healthy lifestyle characteristics. The participants with prehypertension were less likely to have a normal BMI (odds ratio [OR] 0.362; 95% confidence interval [CI] 0.292-0.449) or to be nonsmokers (OR 0.793; 95% CI 0.64-0.982) than those with normal blood pressure. Overall, the prehypertensive participants had a lower likelihood of having four to six (especially all 6) of the healthy lifestyles (OR 0.688; 95% CI 0.561-0.844) than their normotensive counterparts. In addition, some socioeconomic factors, such as family income, had an impact on healthy life habits. CONCLUSION Among children and adolescents, poor prehypertensive status was associated with a low likelihood of healthy lifestyles. Evaluation of multiple healthy lifestyles as a whole should receive more attention for better prevention and control of high blood pressure.
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Affiliation(s)
- Xiaofan Guo
- Department of Cardiology, China Medical University, Shenyang, People's Republic of China
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Gu M, Qi Y, Li M, Niu W. Association of body mass index and alcohol intake with hypertension subtypes among HAN Chinese. Clin Exp Hypertens 2011; 33:518-24. [PMID: 21797798 DOI: 10.3109/10641963.2011.561899] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Obesity and excessive drinking are major risk factors for development of hypertension. We aimed to explore association of body mass index (BMI) and alcohol intake with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic/diastolic hypertension (SDH) among Shandong Shengli Oil field workers. A total of 26,681 subjects were cross-sectionally analyzed. Statistical calculations included polytomous logistic regression and interaction analysis. After assigning normotensives as a reference, the odds of being ISH decreased by 4% for moderate drinkers, whereas that of being IDH and SDH increased significantly by 1.50 and 1.15 folds (P < 0.001). The odds for heavy drinkers of being ISH, IDH, and SDH increased by 1.38, 2.41, and 2.25 folds, respectively (P < 0.001). For BMI, the odds of being ISH, IDH, and SDH increased in a dose-response manner (P < 0.001). For patients with BMI of [23, 25), [25, 27), [27, 30) and ≥ 30 kg/m(2), the odds (95% confidence interval (CI)) of being SDH increased significantly by 2.28 (2.07-2.50), 3.22 (2.93-3.55), 5.44 (4.93-6.01), and 8.45 (7.31-9.77) folds, respectively. Interaction analysis indicated that BMI and alcohol intake were interactively associated with ISH (P ≤ 0.045) rather than IDH (P ≥ 0.161). Our results demonstrated that BMI and alcohol intake interactively influenced systolic hypertension, especially for overweight and obese patients.
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Affiliation(s)
- Mingliang Gu
- Department of Genetics, Beijing Institute of Genomics, Chinese Academy of Sciences, China
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Sesso HD. Alcohol as a Risk Factor and Treatment Target for Hypertension. CURRENT CARDIOVASCULAR RISK REPORTS 2010. [DOI: 10.1007/s12170-010-0119-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Halanych JH, Safford MM, Kertesz SG, Pletcher MJ, Kim YI, Person SD, Lewis CE, Kiefe CI. Alcohol consumption in young adults and incident hypertension: 20-year follow-up from the Coronary Artery Risk Development in Young Adults Study. Am J Epidemiol 2010; 171:532-9. [PMID: 20118194 PMCID: PMC2842215 DOI: 10.1093/aje/kwp417] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 11/20/2009] [Indexed: 12/27/2022] Open
Abstract
The relation between alcohol consumption and incident hypertension is unclear, and most observational studies have not accounted for socioeconomic factors. This study examined the association between alcohol consumption in a diverse group of young adults and incident hypertension over 20 years. Participants (n = 4,711) were from the Coronary Artery Risk Development in Young Adults Study cohort, recruited in 1985 (aged 18-30 years) from Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. The 20-year incidence of hypertension for never, former, light, moderate, and at-risk drinkers was 25.1%, 31.8%, 20.9%, 22.2%, and 18.8%, respectively (P < 0.001). Race, gender, age, family history of hypertension, body mass index, income, education, and difficulty paying for basics and medical care were associated with hypertension. Adjustment using Cox proportional hazard models revealed no association between baseline alcohol consumption and incident hypertension, except among European-American women in whom any current alcohol consumption was associated with lower risk of incident hypertension. The lack of association between alcohol and hypertension in the majority of this socioeconomically diverse cohort is not definitive. Future studies should include social factors, such as income and education, and consider additional characteristics that may modify or confound associations between alcohol and blood pressure.
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Affiliation(s)
- Jewell H Halanych
- University of Alabama at Birmingham,Birmingham, Alabama 35294-4410, USA.
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Kawano Y. Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease. Hypertens Res 2010; 33:181-91. [DOI: 10.1038/hr.2009.226] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Taylor B, Irving HM, Baliunas D, Roerecke M, Patra J, Mohapatra S, Rehm J. Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. Addiction 2009; 104:1981-90. [PMID: 19804464 DOI: 10.1111/j.1360-0443.2009.02694.x] [Citation(s) in RCA: 217] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIMS To analyze the dose-response relationship between average daily alcohol consumption and the risk of hypertension via systematic review and meta-analysis. DESIGN A computer-assisted search was completed for 10 databases, followed by hand searches of relevant articles. Only studies with longitudinal design, quantitative measurement of alcohol consumption and biological measurement of outcome were included. Dose-response relationships were assessed by determining the best-fitting model via first- and second-degree fractional polynomials. Various tests for heterogeneity and publication bias were conducted. FINDINGS A total of 12 cohort studies were identified from the literature from the United States, Japan and Korea. A linear dose-response relationship with a relative risk of 1.57 at 50 g pure alcohol per day and 2.47 at 100 g per day was seen for men. Among women, the meta-analysis indicated a more modest protective effect than reported previously: a significant protective effect was reported for consumption at or below about 5 g per day, after which a linear dose-response relationship was found with a relative risk of 1.81 at 50 g per day and of 2.81 at an average daily consumption of 100 g pure alcohol per day. Among men, Asian populations had higher risks than non-Asian populations. CONCLUSIONS The risk for hypertension increases linearly with alcohol consumption, so limiting alcohol intake should be advised for both men and women.
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Affiliation(s)
- Benjamin Taylor
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Djoussé L, Gaziano JM. Alcohol consumption and heart failure in hypertensive US male physicians. Am J Cardiol 2008; 102:593-7. [PMID: 18721518 DOI: 10.1016/j.amjcard.2008.04.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 04/04/2008] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
Abstract
Although alcohol drinking increases blood pressure and heavy drinking has been associated with alcoholic cardiomyopathy, little is known about the association between light to moderate drinking and risk of heart failure (HF) in hypertensive subjects. Thus, the association between light to moderate drinking and incident HF in 5,153 hypertensive male physicians who were free of stroke, myocardial infarction, or major cancers at baseline was prospectively examined. Alcohol consumption was self-reported and classified as <1, 1 to 4, 5 to 7, and >or=8 drinks/week. HF was ascertained using follow-up questionnaires and validated using Framingham criteria. Average age was 58 years, and about 70% of subjects consumed 1 to 7 drinks/week. A total of 478 incident HF cases occurred in this cohort during follow-up. Compared with subjects consuming <1 drink/week, hazard ratios for HF were 0.89 (95% confidence interval [CI] 0.70 to 1.12), 0.72 (95% CI 0.57 to 0.91), and 0.38 (95% CI 0.20 to 0.72) for alcohol consumption of 1 to 4, 5 to 7, and >or=8 drinks/week after adjustment for age, body mass index, smoking, randomization group, use of multivitamins, vegetable consumption, breakfast cereal, exercise, and history of atrial fibrillation, respectively (p for trend <0.001). Similar results were obtained for subjects with HF with and without antecedent myocardial infarction and those without diabetes mellitus. In conclusion, our data suggested that light to moderate alcohol consumption was associated with a lower risk of HF in hypertensive male physicians.
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Sesso HD, Cook NR, Buring JE, Manson JE, Gaziano JM. Alcohol consumption and the risk of hypertension in women and men. Hypertension 2008; 51:1080-7. [PMID: 18259032 DOI: 10.1161/hypertensionaha.107.104968] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Heavy alcohol intake increases the risk of hypertension, but the relationship between light-to-moderate alcohol consumption and incident hypertension remains controversial. We prospectively followed 28 848 women from the Women's Health Study and 13 455 men from the Physicians' Health Study free of baseline hypertension, cardiovascular disease, and cancer. Self-reported lifestyle and clinical risk factors were collected. In women, total alcohol intake was summed from liquor, red wine, white wine, and beer; men reported total alcohol intake from a single combined question. During 10.9 and 21.8 years of follow-up, 8680 women and 6012 men developed hypertension (defined as new physician diagnosis, antihypertensive treatment, reported systolic blood pressure >or=140 mm Hg, or diastolic blood pressure >or=90 mm Hg). In women, we found a J-shaped association between alcohol intake and hypertension in age- and lifestyle-adjusted models. Adding potential intermediates (body mass index, diabetes, and high cholesterol) attenuated the benefits of alcohol in the light-to-moderate range and strengthened the adverse effects of heavy alcohol intake. Beverage-specific relative risks paralleled those for total alcohol intake. In men, alcohol intake was positively and significantly associated with the risk of hypertension and persisted after multivariate adjustment. Models stratified by baseline systolic blood pressure (<120 versus >or=120 mm Hg) or diastolic blood pressure (<75 versus >or=75 mm Hg) did not alter the relative risks in women and men. In conclusion, light-to-moderate alcohol consumption decreased hypertension risk in women and increased risk in men. The threshold above which alcohol became deleterious for hypertension risk emerged at >or=4 drinks per day in women versus a moderate level of >or=1 drink per day in men.
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Affiliation(s)
- Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston MA 02215-1204, USA.
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Nakamura K, Okamura T, Hayakawa T, Hozawa A, Kadowaki T, Murakami Y, Kita Y, Okayama A, Ueshima H. The Proportion of Individuals with Alcohol-Induced Hypertension among Total Hypertensives in a General Japanese Population: NIPPON DATA90. Hypertens Res 2007; 30:663-8. [PMID: 17917312 DOI: 10.1291/hypres.30.663] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Koshi Nakamura
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
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Abstract
1. The regular consumption of alcohol elevates blood pressure, with global estimates that the attributable risk for hypertensive disease from alcohol is 16%. 2. The increase in blood pressure is approximately 1 mmHg for each 10 g alcohol consumed and is largely reversible within 2-4 weeks of abstinence or a substantial reduction in alcohol intake. 3. This increase in blood pressure occurs irrespective of the type of alcoholic beverage. In particular, the postulated effects of vasodilator flavonoid components of red wine to lessen or reverse alcohol-related hypertension have not been borne out in intervention studies. 4. Heavy drinking, especially a binge pattern of drinking, is linked to a higher incidence of cerebral thrombosis, cerebral haemorrhage and coronary artery disease deaths, although a role for alcohol-related hypertension in the causal pathway is not well defined. 5. In contrast, the light to moderate intake of alcohol has been consistently linked to a reduced risk of atherosclerotic vascular disease end-points. Such a protective effect may also extend to hypertensive subjects. 6. However, the magnitude of any protective effect appears to have been exaggerated because of unmeasured confounders, especially diet, lifestyle and patterns of drinking. Furthermore, a decrease in overall mortality with drinking appears confined to older subjects and to populations with a high background cardiovascular risk profile. 7. Any putative cardiovascular benefits from drinking need to be carefully considered against the effects of alcohol to elevate blood pressure, together with many other adverse health consequences from drinking. Maximum cardiovascular benefit occurs at relatively low levels of consumption (i.e. one to two standard drinks a day in men (10-20 g alcohol) and up to one a day in women (10 g alcohol)). In hypertensive subjects, consumption beyond these levels would be unwise.
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Affiliation(s)
- Ian B Puddey
- Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Nedlands, WA, Australia.
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Nakamura S, Ito Y, Suzuki K, Hashimoto S. Blood pressure, levels of serum lipids, liver enzymes and blood glucose by aldehyde dehydrogenase 2 and drinking habit in Japanese men. Environ Health Prev Med 2006; 11:82-8. [PMID: 21432367 PMCID: PMC2723637 DOI: 10.1007/bf02898147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 01/25/2006] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The association of blood pressure and levels of serum lipids, liver enzymes, blood glucose and aldehyde dehydrogenase 2 (ALDH2) with drinking habit was examined in Japanese men. METHODS The subjects were 264 men aged 39 to 80 years who were classified into the ALDH2 deficiency or sufficiency group using the ethanol patch test and the Tokyo University ALDH2 Phenotype Screening Test. A self-administered questionnaire including drinking habit was used. Blood pressure and the levels of biochemical markers in groups with ALDH2 sufficiency, ALDH2 deficiency and drinking habit were compared using multiple regression models for adjusting age, smoking habit, physical exercising habit and body mass index. RESULTS The levels of serum high-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (γ-GTP) were significantly higher in current drinkers of 20 g of ethanol or more per day than in nondrinkers of the ALDH2 sufficiency group. The levels of serum AST and γ-GTP in current drinkers of 20 g of ethanol or more per day, and fasting blood sugar in current drinkers of less than 20 g of ethanol per day were significantly higher than those in nondrinkers of the ALDH2 deficiency group. CONCLUSIONS These results suggest that alcohol consumption increases the levels of serum lipids and liver enzymes in ALDH2-sufficient individuals and liver enzymes and blood glucose levels in ALDH2-deficient individuals.
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Affiliation(s)
- Sayuri Nakamura
- Department of Adult Nursing, Fujita Health University School of Health Sciences, 1-98 Dengakugakubo, Kutsukake-cho, 470-1192, Toyoake, Aichi, Japan,
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Puddey IB, Beilin LJ. Alcohol and Hypertension. Hypertension 2005. [DOI: 10.1016/b978-0-7216-0258-5.50135-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Päivä H, Lehtimäki T, Laakso J, Ruokonen I, Tervonen R, Metso S, Nikkilä M, Wuolijoki E, Laaksonen R. Dietary composition as a determinant of plasma asymmetric dimethylarginine in subjects with mild hypercholesterolemia. Metabolism 2004; 53:1072-5. [PMID: 15281021 DOI: 10.1016/j.metabol.2003.12.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor that participates in the regulation of vasodilatory function and is also linked to hypertension, whereas its stereoisomere, symmetric dimethylarginine (SDMA), is biologically inactive. Dietary components influence vascular functions and a high-fat meal seems to increase postprandial plasma ADMA levels. However, it has not been published whether diet influences plasma ADMA levels. In this study, we investigated the impact of diet on plasma ADMA and SDMA levels. Thirty-four mildly hypercholesterolemic, otherwise healthy women (n = 14) and men (n = 20) with a mean age of 46.2 years (range, 35 to 62 years) participated in the study. The subjects were examined twice at intervals of 2 months. Seven-day food records were used to analyze diet and alcohol intake. ADMA was measured by using high-performance liquid chromatography (HPLC)-tandem mass spectrometry. In a multivariate analysis (R2 = 0.20, P < .002), low amount of energy received from carbohydrates (r = -0.31, P = .009) and high plasma triglycerides (r = 0.30, P = .01) were predictors of high ADMA plasma levels. Alcohol drinkers had higher plasma ADMA concentrations than abstainers (0.50 +/- 0.13 v 0.42 +/- 0.11 micromol/L, P = .04). Plasma ADMA correlated with systolic (r = 0.60, P = .005) and diastolic blood pressure (r = 0.53, P = .02) in abstainers but not in alcohol drinkers. Plasma SDMA was not associated with any dietary components or with blood pressure. In conclusion, a high amount of dietary carbohydrates is strongly associated with low levels of plasma ADMA. Concentration of ADMA in plasma seems to be higher in alcohol drinkers than in abstainers.
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Affiliation(s)
- Hannu Päivä
- Department of Internal Medicine, Tampere University Hospital, Finland
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Reims HM, Kjeldsen SE, Brady WE, Dahlöf B, Devereux RB, Julius S, Beevers G, De Faire U, Fyhrquist F, Ibsen H, Kristianson K, Lederballe-Pedersen O, Lindholm LH, Nieminen MS, Omvik P, Oparil S, Wedel H. Alcohol consumption and cardiovascular risk in hypertensives with left ventricular hypertrophy: the LIFE study. J Hum Hypertens 2004; 18:381-9. [PMID: 15103313 DOI: 10.1038/sj.jhh.1001731] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Losartan Intervention For End point reduction in hypertension (LIFE) study showed superiority of losartan over atenolol for reduction of composite risk of cardiovascular death, stroke, and myocardial infarction in hypertensives with left ventricular hypertrophy. We compared hazard ratios (HR) in 4287 and 685 participants who reported intakes of 1-7 and >8 drinks/week at baseline, respectively, with those in 4216 abstainers, adjusting for gender, age, smoking, exercise, and race. Within categories, clinical baseline characteristics, numbers randomized to losartan and atenolol, and blood pressure (BP) lowering were similar on the drug regimens. Overall BP control (<140/90 mmHg) at end of follow-up was similar in the categories. Composite end point rate was lower with 1-7 (24/1000 years; HR 0.87, P<0.05) and >8 drinks/week (26/1000 years; HR 0.80, NS) than in abstainers (27/1000 years). Myocardial infarction risk was reduced in both drinking categories (HR 0.76, P<0.05 and HR 0.29, P<0.001, respectively), while stroke risk tended to increase with >8 drinks/week (HR 1.21, NS). Composite risk was significantly reduced with losartan compared to atenolol only in abstainers (HR 0.81 95% confidence interval, CI (0.68, 0.96), P<0.05), while benefits for stroke risk reduction were similar among participants consuming 1-7 drinks/week (HR 0.73, P<0.05) and abstainers (HR 0.72, P<0.01). Despite different treatment benefits, alcohol-treatment interactions were nonsignificant. In conclusion, moderate alcohol consumption does not change the marked stroke risk reduction with losartan compared to atenolol in high-risk hypertensives. Alcohol reduces the risk of myocardial infarction, while the risk of stroke tends to increase with high intake.
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Affiliation(s)
- H M Reims
- Department of Cardiology, Ullevaal University Hospital, Oslo, Norway.
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Yoshimoto K, Komura S, Hattori H, Yamori Y, Miura A, Yoshida T, Hioki C, Kato B, Fukuda F, Tanaka S, Hirai A, Nishimura A, Sawai Y, Yasuhara M. Pharmacological Studies of Alcohol Susceptibility and Brain Monoamine Function in Stroke-Prone Spontaneously Hypertensive Rats (SHRSP) and Stroke-Resistant Spontaneously Hypertensive Rats (SHRSR). TOHOKU J EXP MED 2003; 201:11-22. [PMID: 14609256 DOI: 10.1620/tjem.201.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Differences of alcohol drinking behavior, brain dopamine (DA) and serotonin (5-HT) levels and releases in the striatum were investigated in stroke-prone spontaneously hypertensive rats (SHRSP) and age-matched stroke-resistant spontaneously hypertensive rats (SHRSR). Voluntary alcohol (EtOH) consumption in SHRSP rats increased at 1 and 2 hours in the 4 hour time access. In the DA level, SHRSP showed decreases in the caudate-putamen (C/P) and dorsal raphe nucleus (DRN) compared with in SHRSR. 5-HT levels in the C/P, ventral tegmental area-subtantia nigra (V/S) and DRN of the SHRSP were decreased compared with that in SHRSR. The basal extracellular levels of 5-HT release in the C/P were increased in SHRSP as compared with those in SHRSR. K(+)- or EtOH-induced DA and 5-HT releases in the C/P of the SHRSP were a lower magnitude than those in SHRSR. Increased basal extracellular 5-HT releases showing low levels of 5-HT in the C/P of SHRSP mean an abnormality of serotonergic neuronal functions in a normal physiological condition. Higher voluntary alcohol drinking behavior, so called lower susceptibility to EtOH, in the SHRSP may be associated with the degenerated rewarding system including the DRN. These results suggest that the hypertensive state causes the dysfunction in the striatum of the brain rewarding system and induces the risk for increasing alcohol consumption to compensate for the alteration of serotonergic neurons.
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Affiliation(s)
- Kanji Yoshimoto
- Department of Legal Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
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Nakanishi N, Makino K, Nishina K, Suzuki K, Tatara K. Relationship of Light to Moderate Alcohol Consumption and Risk of Hypertension in Japanese Male Office Workers. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02632.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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