A new meta-analysis looks at the association between alcohol consumption and incidence of hypertension in both men and women. Results show that for men any alcohol intake increases the risk of hypertension, compared to abstainers. For women, there is no increased risk up to 2 drinks per day. This meta-analysis was recently published in the Journal of the American Heart Association.
What is already known? The association between alcohol consumption and hypertension has been extensively studied. Heavy alcohol consumption is known to increase the risk of hypertension in both men and women. The association for light-to-moderate alcohol intake is still unclear. Some studies found protective effects, while other found a negative or no effect.
What does this study add? This meta-analysis studies the relationship between different levels of alcohol consumption and the risk of hypertension for men and women separately. Only high quality observational studies are included. No cause-effect relationship was studied.
This meta-analysis1includes 18 studies with in total more than 360,000 participants. The risk of hypertension in former drinkers was similar compared to lifetime abstainers. For men any alcohol increases the risk of hypertension with 19 – 68%, with a higher risk for higher alcohol intakes. For women however, 1-2 drinks per day did not increase the risk of hypertension. But also no protective effect was found, in contrast with a previous meta-analysis2. Alcohol intakes of more than 3 drinks per day was associated with a 46% increased risk of hypertension in women. No differences were found for different age groups1.
For higher alcohol intake, randomized controlled trials have suggested a causal association. Moreover, studies have found plausible biological pathways for this association1. However, previous studies have found different associations for light-to-moderate alcohol consumption and the risk of hypertension. More research is needed to confirm the association for light-to-moderate alcohol consumption and the underlying mechanism.
Considering the differences between men and women, the researchers suggest that this could be related to differences in alcohol metabolism or differences in drinking pattern (e.g. more binge drinking among men).
Hypertension is also known as high blood pressure. Worldwide it affects about 1 billion people, with a prevalence of almost 20%. It is the third most important risk factor for global burden of disease1. Hypertension is a lifestyle related condition. Risk factors include for example an unhealthy diet, overweight and obesity, lack of physical activity, excessive alcohol consumption and smoking3.
- Separate analysis for men and women
- Different levels of alcohol consumption taken into account
- High quality studies included
- No conclusions on causal relationship
- Drinking patterns (e.g. binge drinking) not taken into account
1. Roerecke, Tobe, S. W., Kaczorowski, J., Bacon, S. L., Vafaei, A., Hasan, O. S. M., Krishnan, R. J., Raifu, A. O., and Rehm, J. Sex-specific associations between alcohol consumption and incidence of hypertension: A systematic review and meta-analysis of cohort studies. Journal of the American Heart Association, vol. 7, nr. 13, 2018.
2. A. Briasoulis, Agarwal, V., and Messerli, F. H. Alcohol Consumption and the Risk of Hypertension in Men and Women: A Systematic Review and Meta-Analysis. Journal of Clinical Hypertension, vol. 14, nr. 11, pp. 792 – 798, 2012.
3. World Health Organization (Europe). Factsheet High Blood Pressure. http://www.euro.who.int/__data/assets/pdf_file/0004/185917/Fact-sheet-World-Health-Day-2013-Eng-final.pdf?ua=1