Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients.
Ethanol consumption is associated with left ventricular dysfunction in heavy ethanol drinkers. The effect of moderate ethanol intake on left ventricular function in hypertension, however, is unknown. We investigated the relationship between ethanol consumption and cardiac changes in nonalcoholic hypertensive patients. In 335 patients with primary hypertension, we assessed daily ethanol consumption by questionnaires that combined evaluation of recent and lifetime ethanol exposure and examined cardiac structure and function by echocardiography. Patients with abnormal liver tests, previous cardiovascular events, left ventricular ejection fraction <50%, and creatinine clearance <30 mL/min 1.72 m2were excluded. Left ventricular hypertrophy was found in 21% of hypertensive patients and diastolic dysfunction was detected in 50% by tissue-Doppler imaging. Ethanol consumption was comparable in hypertensive patients with and without left ventricular hypertrophy, whereas patients with left ventricular diastolic dysfunction had significantly greater consumption than patients with normal ventricular filling. Left atrial diameter, e' wave velocity, e'/a' ratio, and E/e' ratio changed progressively with increasing levels of ethanol consumption, and prevalence of left ventricular diastolic dysfunction increased with a change that became statistically significant in patients consuming 20 g/d of ethanol or more. The e' wave velocity was inversely correlated with ethanol consumption, and multivariate logistic regression indicated that ethanol consumption predicted diastolic dysfunction independently of age, body mass index, blood pressure, insulin sensitivity, and left ventricular mass index. In conclusion, ethanol consumption is independently associated with left ventricular diastolic dysfunction in nonalcoholic hypertensive patients and might contribute to development of diastolic heart failure.
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.). cristiana.catena@uniud.it.
Cristiana
C
Catena
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
GianLuca
G
Colussi
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
Nicolas D
ND
Verheyen
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
Marileda
M
Novello
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
Valentina
V
Fagotto
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
Giorgio
G
Soardo
From the Hypertension Unit (C.C., G.C., M.N., V.F., L.A.S.) and Liver Unit (G.S.), Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Italy; and Department of Cardiology, Medical University of Graz, Austria (N.D.V.).
Leonardo A
LA
Sechi
D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D001795:Blood Pressure Determination; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology; D018450:Disease Progression; D015150:Echocardiography, Doppler; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology*; D006334:Heart Function Tests; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D015994:Incidence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*
blood pressure; diastolic heart failure; echocardiography; ethanol; left ventricular hypertrophy