title: Prevention and Treatment of Hypertension Study (PATHS): effects of an alcohol treatment program on blood pressure.
abstract: OBJECTIVE
  To determine whether blood pressure is reduced for at least 6 months with an intervention to lower alcohol intake in moderate to heavy drinkers with above optimal to slightly elevated diastolic blood pressure, and whether reduction of alcohol intake can be maintained for 2 years.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Six hundred forty-one outpatient veterans with an average intake of 3 or more alcoholic drinks per day in the 6 months before entry into the study and with diastolic blood pressure 80 to 99 mm Hg were randomly assigned to a cognitive-behavioral alcohol reduction intervention program or a control observation group for 15 to 24 months. The goal of the intervention was the lower of 2 or fewer drinks daily or a 50% reduction in intake. A subgroup with hypertension was defined as having a diastolic blood pressure of 90 to 99 mm Hg, or 80 to 99 mm Hg if recently taking medication for hypertension.
  
  
  RESULTS
  Reduction in average weekly self-reported alcohol intake was significantly greater (P<.001) at every assessment from 3 to 24 months in the intervention group vs the control group: levels declined from 432 g/wk at baseline by 202 g/wk in the intervention group and from 445 g/wk by 78 g/wk in the control group in the first 6 months, with similar reductions after 24 months. The intervention group had a 1.2/0.7-mm Hg greater reduction in blood pressure than the control group (for each, P = .17 and P = .18) for the 6-month primary end point; for the hypertensive stratum the difference was 0.9/0.7 mm Hg (for each, P = .58 and P = .44).
  
  
  CONCLUSIONS
  The 1.3 drinks per day average difference between changes in self-reported alcohol intake observed in this trial produced only small nonsignificant effects on blood pressure. The results from the Prevention and Treatment of Hypertension Study (PATHS) do not provide strong support for reducing alcohol consumption in nondependent moderate drinkers as a sole method for the prevention or treatment of hypertension.
authors.affiliation: Veterans Affairs Medical Center, Memphis, Tenn 38104, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Cushman
authors.forename: J A
authors.initials: JA
authors.lastname: Cutler
authors.forename: E
authors.initials: E
authors.lastname: Hanna
authors.forename: S F
authors.initials: SF
authors.lastname: Bingham
authors.forename: D
authors.initials: D
authors.lastname: Follmann
authors.forename: T
authors.initials: T
authors.lastname: Harford
authors.forename: P
authors.initials: P
authors.lastname: Dubbert
authors.forename: P S
authors.initials: PS
authors.lastname: Allender
authors.forename: M
authors.initials: M
authors.lastname: Dufour
authors.forename: J F
authors.initials: JF
authors.lastname: Collins
authors.forename: S M
authors.initials: SM
authors.lastname: Walsh
authors.forename: G F
authors.initials: GF
authors.lastname: Kirk
authors.forename: M
authors.initials: M
authors.lastname: Burg
authors.forename: J V
authors.initials: JV
authors.lastname: Felicetta
authors.forename: B P
authors.initials: BP
authors.lastname: Hamilton
authors.forename: L A
authors.initials: LA
authors.lastname: Katz
authors.forename: H M
authors.initials: HM
authors.lastname: Perry
authors.forename: M L
authors.initials: ML
authors.lastname: Willenbring
authors.forename: R
authors.initials: R
authors.lastname: Lakshman
authors.forename: R J
authors.initials: RJ
authors.lastname: Hamburger
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001794:Blood Pressure / Q000187:drug effects; D000431:Ethanol / Q000494:pharmacology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D000431:Ethanol