Just 7 Drinks per Week Can Raise Risk of Heart Attack and Stroke, Study Finds

Moderate alcohol consumption has been linked to high blood pressure, or hypertension, according to findings to be presented next week at the annual meeting of the American College of Cardiology in New Orleans, Louisiana. The new study is one of the first to suggest moderate drinking is detrimental to heart health. While epidemiological studies in the past have discovered connections between heavy drinking and hypertension, much was left unknown about the same associations concerning only moderate drinking.

The goal of the researchers was to establish associations between alcohol consumption and incidence of elevated blood pressure and stages 1 and 2 hypertension on a large scale.

Hypertension remains the greatest risk factor for heart attack and stroke. Previous studies have connected moderate drinking to a lower risk of some types of heart disease but have failed to address the effect that moderate alcohol consumption has on blood pressure.

The findings suggest that recommendations for alcohol in the Dietary Guidelines for Americans may be revisited when they are reviewed in 2020. Current guidelines for moderate drinking call for no more than 1 drink a day for women and no more than 2 for men, but according to CDC 2 in 3 adults exceed the guidelines at least once per month.

Research has suggested there are multiple factors that explain alcohol’s impact on blood pressure. Alcohol is energy-dense, and its consumption increases appetite, which can lead to a greater overall caloric intake. Spikes in blood pressure can also be caused by alcohol’s activities in the brain and liver.

The authors based their research on extensive data from the CDC’s large, decades long Third National Health and Nutrition Examination Study (NHANES III), which has been considered to be the most accurate representation of the United States population. Researchers analyzed data from 17,059 adults, who had a mean age of 46 years, were 40% white, and were 53% women, who enrolled in the study between 1988 and 1994.

Participants in the study completed questionnaires about their drinking habits and had their blood pressure recorded by qualified personnel. Participants were split into 4 groups, including never-drinkers, former drinkers, moderate drinkers, and heavy drinkers. Moderate drinkers were classified as those who consumed 7 to 13 drinks per week while heavy drinkers were individuals who had 14 or more.

The study’s authors, led by Amer Ismil Aladin, MD, FCAP, FAAFP, cardiology fellow at Wake Forest Baptist Health, conducted cross-sectional analysis on data from NHANES III. They used multivariable logistic regression models adjusted for age, sex, race, income, and cardiovascular risk factors to examine the relationship between alcohol consumption and blood pressure categories using the 2017 ACC/AHA high blood pressure guidelines. The guidelines labeled stage 1 hypertension as having systolic blood pressure between 130 to 139 or diastolic pressure between 80 to 89, and stage 2 as having systolic pressure above 140 or diastolic pressure above 90.

Researchers found that moderate drinkers were 53% more likely to have stage 1 hypertension and twice as likely to have stage 2 compared to never-drinkers. Heavy drinkers were found to be 69% more likely to have stage 1 hypertension and 2.4 times as likely to have stage 2. Never-drinkers had an average blood pressure of 109/67 mm Hg, the average for moderate drinkers was 128/79 mm Hg, and the average for heavy drinkers was 153/82 mm Hg. Results between never and former drinkers had very slight variance.

Aladin believes the contrast with related findings in this field are due to the vast amount of data gathered, which he believes creates a more accurate representation of the total population, considering other studies focused on much smaller sample sizes.

“I think this will be a turning point for clinical practice, as well as for future research, education and public health policy regarding alcohol consumption,” said Aladin. “It’s the first study showing that both heavy and moderate alcohol consumption can increase hypertension.”

The American College of Cardiology's 68th Annual Scientific Session and Exposition takes place March 16-18, 2019.

Reference

Aladin A, Chevli P, Ahmad MI, et al. Alcohol Consumption and Risk of Hypertension. Presented at: 68th American College of Cardiology Scientific Session and Exposition; March 18, 2019; New Orleans; LA. Abstract no. A-15948