Heart disease risk in hypertensive men reduced by moderate alcohol use

High amounts of alcohol consumption are known to increase blood pressure but moderate drinking is associated with a decreased risk of cardiovascular disease. These paradox effects have led to interest in the effect of moderate alcohol consumption on the risk of coronary heart disease (CHD) in patients with hypertension.

Using data from 5164 men during an average follow-up of nearly 18 years in the Physicians’ Health Study, the researchers examined whether alcohol use is associated with a decreased risk of MI in hypertensive participants and they evaluated the relationship between alcohol use and angina pectoris and any CHD, including MI, angina pectoris, coronary artery bypass surgery, or percutaneous coronary intervention.

A total of 623 new cases of myocardial infarction, 1249 cases of angina pectoris, and 1441 cases of total CHD occurred.

The hazard ratios for MI were 1.05, 0.78, and 0.57 for subjects who reported consuming 1 to 4, 5 to 7, and >8 drinks per week compared to those consuming <1 drink per week. Similar results were observed for angina pectoris and total CHD.

Although alcohol has been shown to increase blood pressure, the relatively modest increase in blood pressure is likely countered by the effect of alcohol consumption on insulin sensitivity, inflammation, high-density lipoprotein cholesterol, and platelet aggregation in moderate drinkers.

They emphasize, however, that the effect of moderate alcohol consumption on cardiovascular disease in hypertensive subjects does not negate the importance of controlling blood pressure regardless of drinking habits.

Source :  Am J Cardiol 2009;104:932-935.