title: Alcohol consumption and cardiovascular disease incidence in men with and without hypertension: the Suita study.
abstract: The relationship between alcohol consumption and the risk for cardiovascular disease (CVD) is U-shaped, whereas alcohol drinking is linearly associated with blood pressure, and the CVD risk also increases linearly according to blood pressure level. Accordingly, we investigated the net effect of alcohol consumption and hypertension on CVD and its subtypes in this study. A 13-year prospective study of 2336 Japanese men who were free from CVD was performed; ex-drinkers were excluded. The participants were divided into eight groups classified by the combination of the presence of hypertension (systolic/diastolic blood pressure ≥140/90 mm Hg) and alcohol consumption (never-, current- (light, moderate and heavy) drinkers). Multivariate-adjusted hazard ratios (HRs) for the incidence of CVD, coronary artery disease (CAD) and stroke due to the combination of hypertension and alcohol consumption were calculated and compared with non-hypertensive never-drinkers. The HRs for CVD and its subtypes were higher in hypertensives than those in non-hypertensives; in hypertensives without medication for hypertension, the relationship between alcohol consumption and the risks for CVD and CAD was U-shaped, with the highest and most significant increase in never-drinkers. The risk for total stroke was the highest in heavy-drinkers, which was significant. In non-hypertensives, there was no evident increase or decrease in the HRs for CVD and its subtypes in drinkers. Accordingly, controlling blood pressure is important to prevent CVD. In hypertensives, heavy drinking should be avoided to prevent CVD, although light-to-moderate drinking could be protective for CAD. Furthermore, in non-hypertensives, drinkers may need to continuously monitor their blood pressure.
authors.affiliation: Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Japan. ahigashi@hyo-med.ac.jp
authors.forename: Aya
authors.initials: A
authors.lastname: Higashiyama
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Wakabayashi
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology*; D044466:Asian People / Q000706:statistics & numerical data*; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000208:ethnology*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000208:ethnology*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D020521:Stroke / Q000208:ethnology*