title: Interaction of alcohol and an alpha1-blocker on ambulatory blood pressure in patients with essential hypertension.
abstract: Ingestion of alcohol acutely decreases vascular resistance and blood pressure (BP) with activation of the sympathetic nervous system in Orientals. Although alpha1-blockers are widely used in the treatment of hypertension, the possible interaction between alcohol and alpha1-blockers has not been clarified. We examined the effects of prazosin on the alcohol-induced BP changes in Japanese men with mild hypertension. Ten hypertensive patients (54 +/- 3 years, mean +/- SE) were given 1 mL/kg of alcohol or isocaloric control drink with a light meal in the evening before and 5 to 7 days after treatment with prazosin (1 mg three times daily). Ambulatory BP monitoring was carried out every 30 min for 24 h in each period using Colin ABPM-630. Blood samples were obtained before and 2 h after intake of alcohol or control drink. Before prazosin treatment, alcohol ingestion decreased BP for several hours with a significant reduction in average 24-h BP, whereas it increased heart rate, plasma norepinephrine, and plasma renin activity. Treatment with prazosin caused a significant decrease in 24-h BP (136.3 +/- 4.0/82.8 +/- 2.5 v 131.6 +/- 3.2/80.0 +/- 2.3 mm Hg). The alcohol-induced hypotension at 2-4 h after ingestion was enhanced by prazosin (-18.0 +/- 3.7/-11.8 +/- 2.7 v -24.4 +/- 4.9/-17.8 +/- 2.8 mm Hg, P < .05 for diastolic BP). These results suggested that inhibition of the sympathetic nervous system with alpha1-blockers accentuates alcohol-induced hypotension. Ingestion of alcohol may cause a marked BP reduction in hypertensive Orientals treated with alpha1-blockers.
authors.affiliation: Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Osaka, Japan. ykawano@hsp.ncvc.go.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.forename: H
authors.initials: H
authors.lastname: Abe
authors.forename: S
authors.initials: S
authors.lastname: Kojima
authors.forename: S
authors.initials: S
authors.lastname: Takishita
authors.forename: T
authors.initials: T
authors.lastname: Omae
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002492:Central Nervous System Depressants / Q000494:pharmacology*; D002940:Circadian Rhythm; D003971:Diastole; D004347:Drug Interactions; D000431:Ethanol / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011188:Potassium / Q000097:blood; D011224:Prazosin / Q000627:therapeutic use*; D012083:Renin / Q000097:blood; D013599:Systole
chemical_list: D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D002492:Central Nervous System Depressants; D000431:Ethanol; D012083:Renin; D011188:Potassium; D009638:Norepinephrine; D011224:Prazosin