title: Differential Effect of Initiating Moderate Red Wine Consumption on 24-h Blood Pressure by Alcohol Dehydrogenase Genotypes: Randomized Trial in Type 2 Diabetes.
abstract: OBJECTIVE
  Observational studies report inconsistent associations between moderate alcohol intake and blood pressure (BP). In a sub-study of a larger randomized controlled trial, we assessed the effect of initiating moderate red wine consumption on 24-h BP recordings and the effect of a common genetic variant of alcohol dehydrogenases (ADH) among patients with type 2 diabetes.
  
  
  METHODS
  Fifty-four type 2 diabetes, alcohol abstainers were randomized to consume 150 ml/dinner dry red wine or mineral water. Both groups were guided to adhere to a Mediterranean diet, without caloric restriction. We measured 24-h ambulatory BP monitoring (ABPM) at baseline and after 6 months.
  
  
  RESULTS
  Participants (age = 57 years; 85% men; mean 24-h BP = 129/77 mm Hg) had 92% 6-month retention. After 6 months of intervention, the average 24-h BP did not differ between the wine and water groups. A transient decrease in BP was observed in the red wine group at midnight (3-4 hours after wine intake: systolic BP: red wine = -10.6mm Hg vs. mineral water = +2.3 mm Hg; P = 0.031) and the following morning at 7-9 am (red wine: -6.2mm Hg vs. mineral water: +5.6mm Hg; P = 0.014). In a second post hoc sub-analysis among the red wine consumers, individuals who were homozygous for the gene encoding ADH1B*2 variant (Arg48His; rs1229984, TT, fast ethanol metabolizers), exhibited a reduction in mean 24-h systolic BP (-8.0mm Hg vs. +3.7 mm Hg; P = 0.002) and pulse pressure (-3.8 mm Hg vs. +1.2 mm Hg; P = 0.032) compared to heterozygotes and those homozygous for the ADH1B*1 variant (CC, slow metabolizers).
  
  
  CONCLUSIONS
  Initiating moderate red wine consumption at dinner among type 2 diabetes patients does not have a discernable effect on mean 24-h BP. Yet, a modest temporal BP reduction could be documented, and a more pronounced BP-lowering effect is suggested among fast ethanol metabolizers.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT00784433.
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Yftach
authors.initials: Y
authors.lastname: Gepner
authors.affiliation: Soroka University Medical Center, Beer-Sheva, Israel;
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Henkin
authors.affiliation: Nuclear Research Center Negev, Dimona, Israel;
authors.forename: Dan
authors.initials: D
authors.lastname: Schwarzfuchs
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Rachel
authors.initials: R
authors.lastname: Golan
authors.affiliation: Cardiology Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel;
authors.forename: Ronen
authors.initials: R
authors.lastname: Durst
authors.affiliation: Soroka University Medical Center, Beer-Sheva, Israel;
authors.forename: Ilan
authors.initials: I
authors.lastname: Shelef
authors.affiliation: Soroka University Medical Center, Beer-Sheva, Israel;
authors.forename: Ilana
authors.initials: I
authors.lastname: Harman-Boehm
authors.affiliation: Cardiology Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel;
authors.forename: Shosana
authors.initials: S
authors.lastname: Spitzen
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Shula
authors.initials: S
authors.lastname: Witkow
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Osnat
authors.initials: O
authors.lastname: Tangi-Rosental
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Dana
authors.initials: D
authors.lastname: Sefarty
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Nitzan
authors.initials: N
authors.lastname: Bril
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Michal
authors.initials: M
authors.lastname: Rein
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Noa
authors.initials: N
authors.lastname: Cohen
authors.affiliation: Soroka University Medical Center, Beer-Sheva, Israel;
authors.forename: Yoash
authors.initials: Y
authors.lastname: Chassidim
authors.affiliation: Nuclear Research Center Negev, Dimona, Israel;
authors.forename: Benny
authors.initials: B
authors.lastname: Sarusi
authors.affiliation: Soroka University Medical Center, Beer-Sheva, Israel;
authors.forename: Talia
authors.initials: T
authors.lastname: Wolak
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;
authors.forename: Assaf
authors.initials: A
authors.lastname: Rudich
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; irish@bgu.ac.il.
authors.forename: Iris
authors.initials: I
authors.lastname: Shai
mesh_terms: D000426:Alcohol Dehydrogenase / Q000235:genetics* / Q000378:metabolism; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000201:enzymology / Q000235:genetics / Q000503:physiopathology; D038441:Diet, Mediterranean; D000431:Ethanol / Q000378:metabolism*; D005260:Female; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000201:enzymology / Q000235:genetics / Q000503:physiopathology; D007557:Israel; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D014920:Wine
chemical_list: D000431:Ethanol; C489332:ADH1B protein, human; D000426:Alcohol Dehydrogenase
keywords: ambulatory measurement; blood pressure; hypertension; moderate alcohol; pulse pressure; randomized controlled trial; type 2 diabetes.