Effects of alcohol withdrawal on 24 hour ambulatory blood pressure among alcohol-dependent patients.
BACKGROUND
Although epidemiologic studies have reported an association between alcohol intake and high blood pressure (BP), the results of intervention studies have shown inconsistent results. We embarked on a study to determine whether different subgroups of alcohol-dependent patients may be identified in relation to the effect of alcohol on BP.


METHODS
Fifty alcohol-dependent men (mean age, 41.4 years) received 0.4 g of ethanol per kilogram of body weight every 4 hr in 200 ml of orange juice during 24 hr and the same amount of orange juice without ethanol during another 24 hr. Twenty-four hour ambulatory BP monitoring was performed during ethanol and orange juice intakes, as was hormonal and biochemical analysis.


RESULTS
Thirty-five (75%) alcohol-dependent men were normotensive and 15 (30%) hypertensive. Eighteen (51%) normotensive and 12 (80%) hypertensive subjects showed a significant decrease in 24 hr mean BP after ethanol withdrawal (mean decrease of 8.4 mm Hg [95% confidence interval, -11.2 to -5.7] and 12.5 mm Hg [confidence interval, -16.2 to -8.8], respectively) and were considered as sensitive to alcohol. The remaining alcohol-dependent subjects were considered as resistant to alcohol. Normotensive subjects sensitive to ethanol showed a significantly greater left ventricular mass and a significantly lower ejection fraction than those normotensive patients whose BP did not change after ethanol withdrawal (both p < 0.01).


CONCLUSIONS
More than three fourths of the hypertensive and more than half of the normotensive alcohol-dependent patients showed sensitivity to the pressor effects of ethanol. Impairment also was observed in heart function in normotensive patients sensitive to the pressor effects of ethanol.
Estruch
Ramón
R
Alcohol Unit, Department of Internal Medicine, Hospital Clínic, University of Barcelona, Institut de Investigacions Biomèdiques August Pi i Sunyer, Spain. restruch@medicina.ub.es
Sacanella
Emilio
E
De la Sierra
Alejandro
A
Aguilera
María Teresa
MT
Antúnez
Emília
E
Nicolás
José M
JM
Fernández-Solá
Joaquín
J
Coca
Antonio
A
Urbano-Márquez
Alvaro
A
D000328:Adult; D000437:Alcoholism / Q000503:physiopathology*; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D000431:Ethanol / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*
D000431:Ethanol