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Seo YR, Kim JS, Kim SS, Jung JG, Yoon SJ. Association between Alcohol Consumption and Metabolic Syndrome Determined by Facial Flushing in Korean Women. Korean J Fam Med 2020; 42:24-30. [PMID: 32053860 PMCID: PMC7884890 DOI: 10.4082/kjfm.19.0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 12/29/2019] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to examine the relationship between alcohol consumption and metabolic syndrome in Korean women as determined by facial flushing. Methods Of the female patients aged <65 years who visited the health promotion center at Chungnam National University Hospital from January 2016 to March 2017, 1,344 women were included. After adjusting for confounding factors such as age, body mass index, smoking, exercise, and menopausal status, multiple logistic regression analysis was performed to assess the association between alcohol consumption and the risk of metabolic syndrome in the facial flushing and non-facial flushing groups compared with the non-drinkers. Results Even after adjusting for confounding factors, the risk of metabolic syndrome was significantly high in all drinking subgroups (≤2 standard drinks: odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10–2.68; 2<, ≤4 standard drinks: OR, 2.48; 95% CI, 1.29–4.74; and >4 standard drinks: OR, 4.16; 95% CI, 2.03–8.30) of the facial flushing group. The risk of metabolic syndrome was significantly high only in the subgroup of weekly alcohol consumption >4 standard drinks (OR, 2.20; 95% CI, 1.07–4.52) in the non-facial flushing group. Conclusion This study suggests that Korean women experiencing facial flushing when drinking have a higher risk of developing metabolic syndrome even with a low weekly drinking amount than those who do not experience face flushing.
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Affiliation(s)
- Yu Ri Seo
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jong Sung Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung Soo Kim
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin Gyu Jung
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Seok Jun Yoon
- Department of Family Medicine, Research Institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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Di Gennaro C, Saccani-Jotti G, Pinelli S, Venturi N, Palombi F, Manfredi G, Pellegrino A, Bicchieri L, Sansoni P, Montanari A. Endothelial dysfunction and high cardiovascular risk profile in severe alcoholics improve only partially following a medium-term alcohol withdrawal. Alcohol Clin Exp Res 2011; 36:242-50. [PMID: 22013918 DOI: 10.1111/j.1530-0277.2011.01636.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about brachial artery flow-mediated vasodilatation (FMD) in active and medium-term withdrawing heavy alcoholics (HA). METHODS FMD and some parameters of cardiovascular (CV) risk were measured in 29 HA (average alcohol intake 135, range 86 to 215 g per day) at baseline and after a 9 ± 7 months withdrawal and in 35 teetotalers. RESULTS HA showed baseline impaired maximal % FMD (8.5 ± 5.4 SD vs. 14.9 ± 7.4, <0.001 vs. teetotalers), higher systolic (SBP) and diastolic (DBP) blood pressure (+24 mm Hg, <0.001; +15 mm Hg, <0.01), uric acid (5.3 ± 1.1 vs. 4.4 ± 0.8 mg/dl, <0.05), high-sensitivity C-reactive protein (hs-CRP; 2.7 ± 2.0 vs. 1.0 ± 0.9 mg/l, <0.02), endothelin-1 (ET-1, 0.88 ± 0.36 vs. 0.37 ± 0.10 pg/ml,<0.001), asymmetric dimethylarginine (ADMA, 0.50 ± 0.21 vs. 0.41 ± 0.12 μmol/l, p < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (2.3 ± 1.1 vs. 1.2 ± 0.4, <0.001), and urinary 8-isoprostane (U8-iso-PGF2α) (237.2 ± 172.4 vs. 168.5 ± 96.6 pg/mg creatinine, <0.05). After withdrawal, SBP fell by 15 mm Hg, DBP by 11 mm Hg (p < 0.001), and hs-CRP by 0.94 mg/l (p < 0.02), all remaining still higher than teetotalers (<0.05, 0.01, 0.05 respectively). ET-1, HOMA-IR, and U8-iso-PGF2α were unchanged (p = NS vs. baseline, <0.05 to 0.001 vs. teetotalers). Maximal % FMD rose (to 10.6 ± 6.2, p < 0.04), but it still remained impaired (<0.04 vs. teetotalers). ADMA increased further to 0.64 ± 0.15 μmol/l (<0.05 vs. baseline, <0.02 vs. teetotalers). CONCLUSIONS HA show marked endothelial dysfunction (ED) and high BP, impaired insulin sensitivity, inflammation, increased oxidative stress, and elevated ET-1 and ADMA, which are unaffected or only partially reversed by a medium-term alcohol withdrawal. ED and related abnormalities persist in detoxified alcoholics, thus contributing to a greater CV morbidity and mortality.
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Affiliation(s)
- Cristiana Di Gennaro
- Centro di Alcologia at the Dipartimento di Medicina Interna e Scienze Biomediche, University of Parma Medical School, Parma, Italy
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Di Gennaro C, Biggi A, Barilli AL, Fasoli E, Carra N, Novarini A, Delsignore R, Montanari A. Endothelial dysfunction and cardiovascular risk profile in long-term withdrawing alcoholics. J Hypertens 2007; 25:367-73. [PMID: 17211243 DOI: 10.1097/hjh.0b013e328010929c] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Rates of cardiovascular morbidity and mortality are greater in heavy alcoholics than in either teetotallers or light-to-moderate drinkers. OBJECTIVE On the assumption that factors leading to atherosclerotic damage remain operative even after long-term alcohol withdrawal, we studied the possible mechanisms of raised cardiovascular risk in former heavy alcoholics. METHODS Forty-two apparently disease-free, normotensive alcoholics detoxified for 37.1 +/- 31.9 (SD) months, median 24, participated in the study. They were compared with 39 lifetime alcohol-abstaining control subjects, carefully matched for age, sex, body mass index, smoking and dietary habits, physical activity, lipids and fasting glucose. Endothelial function (flow-mediated dilation of brachial artery, high-resolution ultrasound technique), blood pressure, and some parameters of endothelial activation, oxidative stress, vascular inflammation and insulin sensitivity were measured. RESULTS The maximal percentage of flow-mediated dilatation was reduced in detoxified alcoholics (10.1 +/- 4.6 versus 14.9 +/- 7.4, P < 0.001) who also showed significantly higher blood pressure (systolic 127.5 +/- 12.9 versus 118.2 +/- 10.7 mmHg, P < 0.001; diastolic 79.4 +/- 7.1 versus 74.6 +/- 6.4 mmHg, P < 0.01; mean 95.4 +/- 8.2 versus 89.1 +/- 7.3 mmHg, P < 0.001), uric acid (5.0 +/- 1.1 versus 4.4 +/- 0.8 mg/dl, P < 0.05), high-sensitivity C-reactive protein (2.1 +/- 2.0 versus 1.0 +/- 0.9 mg/l, P < 0.01), endothelin-1 (0.38 +/- 0.11 versus 0.17 +/- 0.10 pg/ml, P < 0.001) and fasting insulin (10.4 +/- 4.5 versus 5.6 +/- 1.6 muU/ml, P < 0.001) with abnormal homeostasis model assessment index of insulin resistance (2.3 +/- 1.1 versus 1.2 +/- 0.4, P < 0.001). CONCLUSION Previous heavy alcoholism, in spite of long-term withdrawal, is associated with endothelial dysfunction and a wide cluster of haemodynamic, vascular and metabolic abnormalities that indicate an unfavourable cardiovascular and metabolic risk profile even in apparently disease-free former alcoholics.
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Affiliation(s)
- Cristiana Di Gennaro
- Center for Study and Treatment of Alcoholism, Dipartimento di Medicina Interna e Scienze Biomediche, University of Parma, Parma, Italy
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Ceccanti M, Sasso GF, Nocente R, Balducci G, Prastaro A, Ticchi C, Bertazzoni G, Santini P, Attilia ML. HYPERTENSION IN EARLY ALCOHOL WITHDRAWAL IN CHRONIC ALCOHOLICS. Alcohol Alcohol 2005; 41:5-10. [PMID: 16234285 DOI: 10.1093/alcalc/agh221] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Hypertension is an established risk factor in chronic alcoholics, but little is known about the relationship between blood pressure (BP), severity of their alcohol abuse, and severity of alcohol withdrawal syndrome (AWS). METHOD BP was assessed daily for 18 days in a series of chronic alcoholics on early alcohol withdrawal (AW), while also assessing the severity of their AWS on the CIWA-Ar scale. RESULTS A sharp and sustained decrease in BP was observed after AW; at T0, BP had increased in 55% of patients, and at T18 in 21%. The variation of BP is partially explained by years of at-risk drinking and AWS severity, but other factors may play a role in hypertension in alcoholics, as a large amount of BP variation was not explained by the alcohol-abuse-related parameters that we studied. BP values were not correlated with cigarette smoking, anxiety, or depression. Hypertension found in 'detoxified' alcoholics (approximately 20%) may be related to alcohol-independent hypertension or to a long-lasting alcohol-induced derangement of the BP regulating mechanisms. Further research is needed in these patients to elucidate the mechanisms of persistent hypertension and to set up a treatment protocol. At present, careful monitoring is advisable, as well as pharmacological treatment for moderate or severe hypertension; often a modification of life-style is needed which includes physical activity and possibly sodium (Na) restriction, since hypertension in detoxified alcoholics seems to be Na sensitive. CONCLUSION Complete alcohol abstinence must be recommended to all hypertensive alcoholics, as AW-induced transient hypertension was found to be harmless in all our subjects, and abstinence leads to a complete recovery from hypertension in most cases.
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Affiliation(s)
- M Ceccanti
- Alcohol Unit, University La Sapienza, Rome.
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Hong EH, Kang NY, Kim JA, Koo TB, Kang BS, Kim IK. BRIEF EXPOSURE TO ETHANOL AUGMENTS VASCULAR CONTRACTILITY IN HUMAN CHORIONIC PLATE ARTERIES. Clin Exp Pharmacol Physiol 2004; 31:338-41. [PMID: 15191408 DOI: 10.1111/j.1440-1681.2004.04007.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Heavy alcohol consumption has been known as a risk factor for hypertension, although the mechanism by which alcohol intake causes hypertension remains elusive. We tested the hypothesis that brief exposure to ethanol augments vascular contractility through the stress response in human chorionic plate arteries. Human chorionic plate arteries were mounted in organ baths and exposed to 5% ethanol for 15, 30 or 45 min. Brief exposure for 45 min, but not 15 min, not only augmented contractility to KCl and 5-hydroxytryptamine 5 h after the end of exposure, but also increased the expression of heat shock protein (HSP) 70 in the tissues. Reverse transcription-polymerase chain reaction showed gradual increases of hsp70 mRNA expression, but not heat shock cognate 70 (hsc70), hsp90alpha or glucose regulatory protein 78 (grp78) mRNA expression, in an exposure time-dependent manner 3 h after the end of exposure. These results indicate that ethanol augments vascular contractility through the stress response.
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Affiliation(s)
- Eun Hui Hong
- Department of Pharmacology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Gennaro C, Vescovi PP, Barilli AL, Giuffredi C, Delsignore R, Montanari A. Sodium Sensitivity as a Main Determinant of Blood Pressure Changes during Early Withdrawal in Heavy Alcoholics. Alcohol Clin Exp Res 2002. [DOI: 10.1111/j.1530-0277.2002.tb02487.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Keil U, Liese A, Filipiak B, Swales JD, Grobbee DE. Alcohol, blood pressure and hypertension. NOVARTIS FOUNDATION SYMPOSIUM 1999; 216:125-44; discussion 144-51. [PMID: 9949791 DOI: 10.1002/9780470515549.ch9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In the last 30 years a large number of cross-sectional studies, a smaller number of prospective cohort studies and several intervention studies have addressed the alcohol-blood pressure relationship. Although a number of questions--such as the validity of measurement of alcohol intake, shape of the alcohol-blood pressure relationship, threshold dose for hypertension, and plausible pathophysiological mechanisms--have not yet been answered satisfactorily, it is clear that a causal association exists between chronic intake of > or = 30-60 g alcohol per day and blood pressure elevation in men and women. To call the alcohol-blood pressure relationship causal is justified because chance and, to a large degree, bias and confounding, have been ruled out as plausible explanations in most observational studies. More importantly, the intervention studies support the observational studies and show a remarkable consistency in demonstrating a potentially valuable decrease in blood pressure when heavy drinkers abstain or restrict their alcohol intake. From the different studies a rule of thumb can be derived: above 30 g of alcohol intake per day an increment of 10 g of alcohol per day increases on average systolic blood pressure by 1-2 mmHg and diastolic blood pressure by 1 mmHg.
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Affiliation(s)
- U Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Germany
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Abstract
Tissue or organ system damage resulting from alcohol ingestion typically requires several years of heavy drinking to reach clinical significance. Based upon earlier empirical findings and theorizing, we hypothesized that the lifetime number of exposures (drinking days) may be of significance in understanding the relationship between chronic alcohol consumption and organ system perturbations in alcoholic populations. To test this hypothesis, detailed lifetime alcohol consumption histories from a racially mixed cohort of detoxified alcoholics (n = 253) and nonalcoholics (n = 61) were examined to determine the lifetime total number of drinking days. Linear regressions corrected for lifetime total dose and pertinent confounding variables yielded statistically significant correlations of moderate size of the number of lifetime alcohol drinking days with diastolic blood pressure and quadriceps muscle strength. The findings were considered to provide evidence that an alcohol exposure (drinking day), independent of dose, is a biologically significant event in the genesis of tissue toxicities in the cohorts studied.
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Affiliation(s)
- J L York
- Research Institute on Addictions, Buffalo, NY 14203, USA.
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Friedman HS. Cardiovascular effects of alcohol. RECENT DEVELOPMENTS IN ALCOHOLISM : AN OFFICIAL PUBLICATION OF THE AMERICAN MEDICAL SOCIETY ON ALCOHOLISM, THE RESEARCH SOCIETY ON ALCOHOLISM, AND THE NATIONAL COUNCIL ON ALCOHOLISM 1998; 14:135-66. [PMID: 9751945 DOI: 10.1007/0-306-47148-5_6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The ingestion of one or two alcoholic drinks can affect heart rate, blood pressure, cardiac output, myocardial contractility, and regional blood flow. These actions generally are not clinically important. In the presence of cardiovascular disease, however, even such small quantities of alcohol might result in transient unfavorable hemodynamic changes. Moreover, alcohol abuse can produce cardiac arrhythmias, hypertension, cardiomyopathy, stroke, and even sudden death. In contrast, moderate alcohol use produces changes that have an overall favorable effect on atherosclerotic-related vascular diseases. Because cardiovascular disease due to atherosclerosis is the leading cause of death in Western society, this desirable effect of alcohol use outweighs its detrimental actions, resulting in favorable findings in population studies. Nevertheless, the body of evidence argues against encouraging alcohol use for its cardiovascular effects.
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Affiliation(s)
- H S Friedman
- Department of Medicine, Long Island College Hospital, Brooklyn, New York, USA
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Rakic V, Puddey IB, Burke V, Dimmitt SB, Beilin LJ. Influence of pattern of alcohol intake on blood pressure in regular drinkers: a controlled trial. J Hypertens 1998; 16:165-74. [PMID: 9535143 DOI: 10.1097/00004872-199816020-00006] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effects of patterns of drinking (weekend versus daily drinking) on the pressor responses to alcohol in 55 male drinkers using clinic and 24 h ambulatory blood pressure monitoring. DESIGN A randomized, controlled cross-over trial. METHODS Recruitment required a regular alcohol intake of 210-500 ml absolute alcohol/week, with > 60% consumed as beer. Fourteen subjects were categorized as predominantly weekend drinkers, whereas the remaining 41 subjects regularly drank on a daily basis. After 4 weeks of familiarization, all subjects were randomly allocated to drinking low-alcohol beer (0.9% vol:vol) only or to maintain their usual drinking habits with provision of full-strength beer (5% vol:vol) for 4 weeks. They then switched back to their usual drinking habits or low-alcohol beer, respectively, for a further 4 weeks while maintaining their usual drinking pattern. RESULTS Baseline ambulatory systolic blood pressure in weekend but not in daily drinkers was 2.4 mmHg higher on Monday than it was on Thursday (P = 0.02). This Monday-Thursday difference was lost during intervention. When subjects switched from the high-alcohol to the low-alcohol period the falls in ambulatory systolic blood pressure in weekend (3.1 mmHg, P < 0.001) and daily drinkers (2.2 mmHg, P < 0.001) were similar. Most of the fall was evident during week 1 of the low-alcohol period for weekend drinkers but not until week 4 for daily drinkers. CONCLUSION The pressor response to alcohol consumption is similar in magnitude in weekend and daily drinkers, present throughout a 24 h period and has a rapid onset/offset in weekend drinkers but is more sustained in daily drinkers.
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Affiliation(s)
- V Rakic
- University Department of Medicine, Royal Perth Hospital, and the West Australian Heart Institute.
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PUDDEY IANB, BEILIN LAWRENCEJ, RAKIC VALENTINA. Alcohol, hypertension and the cardiovascular system: a critical appraisal. Addict Biol 1997; 2:159-70. [PMID: 26735633 DOI: 10.1080/13556219772705] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cross-sectional and longitudinal population studies have provided a considerable corpus of evidence for an inverse association between light to moderate alcohol intake and both coronary artery disease and stroke. The formulation of balanced public health advice on the basis of such studies, however, needs to take into account the full spectrum of the effects of alcohol on the cardiovascular system, particularly its equally well documented effect to increase level of blood pressure and prevalence of hypertension. In this review, the broader implications of the association of alcohol with hypertension are discussed, principally in the context of the effect of higher levels of alcohol consumption to increase ischaemic and haemorrhagic stroke, left ventricular hypertrophy, congestive cardiomyopathy, cardiac arrhythmia and sudden cardiac death.
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