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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Observational studies and clinical experiments solidly establish an empiric relationship between heavy drinking (>/= 3 standard drinks/day) and higher blood pressure. A biologic mechanism for this link remains unclear. It has been difficult to study the incidence of usual hypertension sequelae in alcohol-associated hypertension because of complex interactions of alcohol, hypertension and cardiovascular conditions. Even with these limitations, a causal association is the most likely explanation and control of alcohol intake is probably important in prevention and treatment of hypertension.
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PMID:Alcohol and cardiovascular disease--more than one paradox to consider. Alcohol and hypertension: does it matter? Yes. 1256 33

A population-based health interview and examination survey of 8 Inuit communities in the Kivalliq region of Nunavut, Canada, during the early 1990s has resulted in an increased understanding of the burden and extent of cardiovascular diseases and diabetes and their risk factors such as genetics, obesity, lipids, blood pressure and fatty acids. A recent national health interview survey which included a sample from Nunavut indicates that the Inuit still enjoy some advantages relative to other Canadians (lower level of self-reported diabetes and hypertension) and disadvantages (higher level of smoking, obesity, and heavy drinking). The pattern of health and disease among the Inuit is rapidly evolving, as the traditional lifestyle becomes further eroded. A long-term prospective cohort study that monitors this trend, investigates the etiology, and identifies potential interventions is urgently needed.
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PMID:Contributions to chronic disease prevention and control: studies among the Kivalliq Inuit since 1990. 1496 61

Alcohol biomarkers such as carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase (GGT) have significant potential for enhancing the quality of medical treatment in primary health care settings. Recent studies demonstrate that these laboratory tests can help the general practitioner in several ways. First, CDT and GGT can detect current heavy drinking in primary care patients with a fair degree of sensitivity (approximately 60% to 70%), with CDT being more specific (approximately 90%). When combined with self-report tests, they can provide a clinically useful alcohol screening battery. Second, elevated CDT and GGT levels have been correlated with specific alcohol-sensitive diseases (e.g., hypertension) and, as such, can serve as risk indicators for those diseases. Third, alcohol biomarkers have proven to be useful in monitoring the effectiveness of brief alcohol interventions with medical patients. Unfortunately, preliminary findings indicate that physicians have little knowledge of current biomarker research as applied to primary health care. Translational studies are needed on methods to facilitate knowledge and use of alcohol biomarkers by general practitioners.
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PMID:Biochemical alcohol screening in primary health care. 1534 74

Epidemiological studies have demonstrated a positive relationship between heavy alcohol use and hypertension, but few studies have directly addressed the role of drinking pattern. This study was designed to investigate the association of current alcohol consumption and aspects of drinking pattern with hypertension risk in a sample of 2609 white men and women from western New York, aged 35 to 80 years, and free from other cardiovascular diseases. Hypertension was defined by systolic blood pressure > or =140 mm Hg or diastolic blood pressure > or =90 mm Hg or use of antihypertensive medication. Odds ratios (95% confidence intervals) were computed after adjustment for several covariates. Compared with lifetime abstainers, participants reporting drinking on a daily basis (1.75 [1.13 to 2.72]) or mostly without food (1.64 [1.08 to 2.51]) exhibited significantly higher risk of hypertension. When analyses were restricted to current drinkers, daily drinkers and participants consuming alcohol without food exhibited a significantly higher risk of hypertension compared with those drinking less than weekly (1.65 [1.18 to 2.30]) and those drinking mostly with food (1.49 [1.10 to 2.00]), respectively. After additional adjustment for the amount of alcohol consumed in the past 30 days, the results were follows: 0.90 (0.58 to 1.41) for daily drinkers and 1.41 (1.04 to 1.91) for drinkers without food. For predominant beverage preference, no consistent association with hypertension risk was found across the various types of beverages considered (beer, wine, and liquor). In conclusion, drinking outside meals appears to have a significant effect on hypertension risk independent of the amount of alcohol consumed.
Hypertension 2004 Dec
PMID:Relationship of alcohol drinking pattern to risk of hypertension: a population-based study. 1549 32

There is considerable debate about the association between individual socio-economic status, community socio-economic status and health. The current study examines individual data from a case-control study of stroke (n = 3489) conducted in Auckland, New Zealand. The study sought to identify whether individual socio-economic status (as measured by income from lifetime occupation) and community socio-economic status (measured in a number of ways) predicts the onset of stroke both independently and after controlling for individual risk factors (e.g., smoking, obesity and hypertension). Logistic regression results show that individual socio-economic status and all of the community socio-economic status measures predict the onset of stroke before controlling for individual risk factors. However, there is a high correlation between the various measures of community socio-economic status. Stepwise regression results suggest that average household income is the measure of community-level socio-economic status with the greatest predictive power. The results suggest that individual income and average household income are significant predictors of onset of stroke both independently and after controlling for behavioural and medical risk factors. Logistic regression analysis of the pathway suggests that individual income is a significant predictor of smoking and obesity, and that community socio-economic status is a significant predictor of heart disease, heavy drinking, diabetes, smoking and obesity.
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PMID:Individual socio-economic status, community socio-economic status and stroke in New Zealand: a case control study. 1597 Feb 29

Myocardial damage from heavy alcohol intake can cause the heart failure (HF) syndrome, but the relation of lighter alcohol intake to HF has rarely been studied. We examined the risk of HF hospitalization among 126,236 subjects who supplied data about alcohol during health examinations from 1978 to 1985. Among 2,594 subjects who were subsequently hospitalized for HF, record review established an association between coronary artery disease (CAD) and HF (CAD-HF) in 1,559 patients. Among the remaining 1,035 subjects who had HF (non-CAD-HF), we attempted determination of preponderant etiologic and contributory factors. Analyses used Cox models that were controlled for 7 covariates, with usual alcohol intake studied categorically compared with that in subjects who did not drink alcohol. Heavier drinkers (> or =3 drinks/day) but not light to moderate drinkers had increased risk of non-CAD-HF; e.g., relative risk for subjects who reported > or =6 drinks/day was 1.7 (95% confidence interval 1.1 to 2.6). This association of non-CAD-HF with heavy drinking was limited to subsets with cardiomyopathy or of unclear preponderant etiology. Alcohol drinking was inversely related to risk of CAD-HF (e.g., at 1 to 2 drinks/day, relative risk 0.6, 95% confidence interval 0.5 to 0.7), with consistency across subgroups of age, gender, ethnicity, education, smoking status, interval to diagnosis, and presence or absence of baseline heart disease or systemic hypertension. Moderate drinking was inversely related to non-CAD-HF only in subjects who had diabetes mellitus (n = 252). In conclusion, heavy, but not light, alcohol drinking is associated with increased risk of non-CAD-HF and that apparent protection by alcohol drinking against CAD-HF risk provides confirmation of a protective effect of alcohol against CAD.
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PMID:Alcohol drinking and risk of hospitalization for heart failure with and without associated coronary artery disease. 1605 55

Substantial evidence demonstrates that: 1) heavy alcohol consumption (three or more standard drinks per day) is associated with and predictive of hypertension; 2) reduction in alcohol consumption is associated with a significant dose-dependent lowering of mean systolic and diastolic blood pressure; and 3) physician advice can reduce heavy drinking in hypertensive patients. These findings suggest that the routine evaluation of alcohol consumption in hypertensive patients is warranted. The Alcohol Use Disorders Identification Test-C (AUDIT-C), a brief, three-question screening test, is useful in this regard. Alcohol biomarkers can also play a role in detecting and monitoring heavy drinking in hypertensive patients whose self-reports on the AUDIT-C are suspect. Carbohydrate-deficient transferrin, a new alcohol biomarker with high specificity, can provide objective data for feedback and counseling. A routine search for excessive use of alcohol, along with brief interventions and monitoring, can have a major impact on reducing the prevalence of hypertension in the general population.
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PMID:Excessive alcohol consumption and hypertension: clinical implications of current research. 1608 98

The association of lifetime alcohol drinking pattern with the prevalence of the metabolic syndrome is largely unknown. Analyses were conducted on a population-based sample in a cross-sectional study (N=2818, ages 35-79 years, 93% whites). Included were subjects who drank at least once a month for a period of at least six months during their lifetimes and were free of cardiovascular disease and cancer at the time of interview. Lifetime drinking measures included total years of drinking, total drinking days, volume (total drinks) and average intensity (#drinks/drinking day); frequency of intoxication and heavy drinking; and age drinking began and ended. Metabolic syndrome components included impaired fasting glucose (IFG), high triglycerides (HTG), low HDL cholesterol (LHDLC), abdominal obesity (ABO), and hypertension (HBP). Potential confounders examined were age, gender, race, family history of coronary heart disease or diabetes, years of education, lifetime and current cigarette smoking, current drinking status, physical activity, and dietary factors. Multiple logistic regressions indicated that average intensity was directly related to IFG, HTG, HBP, and metabolic syndrome overall (p for linear trend=0.03, 0.04, 0.003, and 0.009, respectively) and to ABO in women only (p for trend=0.0004). Prevalence ratios (95% CI) for the metabolic syndrome according to quartiles of intensity were 1.00 (lowest), 1.23 (0.91-1.67), 1.43 (1.06-1.91) and 1.60 (1.12-2.30). Total drinking days was inversely related to LHDLC (p for trend=0.0002) and to ABO in women only (p for trend<0.0001). It is concluded that lifetime drinking patterns are significantly related to the prevalence of the metabolic syndrome.
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PMID:Lifetime alcohol drinking pattern is related to the prevalence of metabolic syndrome. The Western New York Health Study (WNYHS). 1651 81

Several factors for chronic kidney disease (CKD), including diabetes, hypertension, and obesity, are described consistently in the literature; studies describing modifiable lifestyle factors, including smoking and consumption of alcohol, are sparse, sometimes contradictory. The authors examined the factors associated with CKD in a population-based cohort in Wisconsin, with emphasis on smoking and consumption of alcohol. CKD was defined as an estimated glomerular filtration rate of less than 60 ml/minute per 1.73 m(2) from serum creatinine. The authors performed two analyses: 1) cross-sectional analysis among 4,898 persons with prevalent CKD (n = 324) as the outcome of interest and 2) longitudinal analysis among 3,392 CKD-free persons at baseline, with 5-year incident CKD (n = 114) between 1993 and 1995 as the outcome of interest. Smoking and heavy drinking, defined as consumption of four or more servings of alcohol per day, were associated with CKD, independent of several important confounders. Compared with that among never smokers, the odds ratio of developing CKD was 1.12 (95% confidence interval (CI): 0.63, 2.00) among former smokers and 1.97 (95% CI: 1.15, 3.36) among current smokers. Heavy drinking was associated with CKD, with an odds ratio of 1.99 (95% CI: 0.99, 4.01). Joint exposure to both current smoking and heavy drinking was associated with almost fivefold odds of developing CKD compared with their absence (odds ratio = 4.93, 95% CI: 2.45, 9.94). Smoking and consumption of four or more servings of alcohol per day are associated with CKD.
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PMID:The association among smoking, heavy drinking, and chronic kidney disease. 1738 12

Unhealthy alcohol use is among the leading causes of morbidity and mortality in the United States. Among military personnel, service members between the ages 18 and 25 had a 27.3% prevalence of heavy drinking in the previous 30 days, compared to 15.3% among civilians in the same age group. In the civilian world, > 100 million patients are treated in U.S. emergency departments (ED) annually; 7.9% of these visits are alcohol related. Alcohol is associated with a broad range of health consequences that may ultimately present in the ED setting: traumatic injuries (e.g., motor vehicle crashes, intentional violence, falls); environmental injuries (e.g., frostbite); cardiovascular problems (e.g., hypertension, dilated cardiomyopathy); gastrointestinal disorders (e.g., hepatitis, pancreatitis, gastrointestinal bleeding); neurological problems (e.g., encephalopathy, alcohol withdrawal, withdrawal seizures), as well as psychological problems (e.g., depression, suicide). Seminal work has been done to create behavioral interventions for at-risk drinkers. These motivational interventions have been found to be successful in encouraging clients to change their risky behaviors. We present such a technique, called the Brief Negotiated Interview as performed in a civilian ED setting, in hopes of adapting it for use in the military context. Military health care providers could easily adapt this technique to help reduce risky levels of alcohol consumption among service members, retirees, or military dependents.
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PMID:Brief interventions to reduce harmful alcohol use among military personnel: lessons learned from the civilian experience. 1680 38


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