medwireNews: Both moderate and high alcohol consumption are independently associated with hypertension in people with type 2 diabetes and cardiovascular disease (CVD), and the risk rises with increasing consumption, ACCORD study data suggest.
“In light of our findings, low risk and simple lifestyle modifications to temper alcohol consumption may have the potential for clinical and public health benefits via decreased rates of hypertension,” write Matthew Singleton and co-authors in the Journal of the American Heart Association.
Singleton and team found that light alcohol consumption, defined as between one and seven drinks per week, was not associated with any degree of hypertension among the 10,200 ACCORD participants they analyzed.
These individuals had a mean age of 63 years, a mean type 2 diabetes duration of around 10.5 years, and either a history of CVD, evidence of potential CVD, or at least two additional CVD risk factors. For the trial, they were randomly assigned to undergo tight or standard glycemic control, with subgroups also randomly assigned to intensive versus standard blood pressure or lipid control to investigate whether CVD event rates could be reduced in people with type 2 diabetes.
The current post-hoc analysis showed that moderate alcohol consumption (8–14 drinks/week) was significantly associated with an increased likelihood of elevated blood pressure (120–129/<80 mmHg), at an odds ratio (OR) of 1.79, as well as an increased risk for stage 1 hypertension (130–139/80–89 mmHg) and stage 2 hypertension (≥140/90 mmHg), at ORs of 1.66 and 1.62, respectively.
And the odds were even higher among heavy drinkers (≥15 drinks/week), at 1.91, 2.49, and 3.04, for elevated blood pressure and stage 1 and 2 hypertension, respectively.
Singleton and team note that previous research has not shown an association between moderate alcohol consumption and hypertension, and suggest that their findings could be due, in part, to recent reductions in guideline thresholds for hypertension.
They also comment that the cross-sectional study design cannot rule out residual confounding bias “especially in the context of noting prior literature supporting a potential cardiovascular benefit with moderate alcohol consumption versus our findings that suggest a risk of hypertension, albeit in patients with type 2 diabetes mellitus.
Nonetheless, the authors conclude: “Although heavy alcohol consumption has a clearly recognized association with hypertension, we add to this well-established body of knowledge by showing moderate alcohol consumption may also be implicated in its association with hypertension, specifically in patients with type 2 diabetes mellitus.”
They add: “The translational possibilities of these findings with respect to the low risk nature of intervention, such as alcohol cessation counseling, should be considered.”
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