Alcohol Raises Hypertension Risk in People With Diabetes

The relationship between heavy alcohol consumption and high blood pressure has been established for over a hundred years. Many studies have shown that it hardly matters what kind of alcohol is involved, and the relationship exists independent of a person’s age, weight and education level, as well as whether someone is a smoker, is overweight or consumes a lot of salt.

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But researchers know less about the effects of moderate alcohol consumption, and even less about the relationship between drinking alcohol and type 2 diabetes. Although research conducted so far has not found a connection between alcohol and diabetes, a study just published in the Journal of the American Heart Association reports that moderate drinking is associated with a 60% or higher chance of high blood pressure in peoples with type 2 diabetes. According to lead study author Matthew J. Singleton, MD, of the Wake Forest University School of Medicine, “This is the first large study to specifically investigate the association of alcohol intake and hypertension among adults with type 2 diabetes. Previous studies have suggested that heavy alcohol consumption was associated with high blood pressure, however, the association of moderate alcohol consumption with high blood pressure was unclear.”

The study was based on an analysis of more than 10,000 people with diabetes who were participants in what’s known as the ACCORD Trial (Action to Control Cardiovascular Risk in Diabetes), which was one of that largest trials ever conducted to examine the relationship between heart disease and type 2 diabetes. It took place from 2001 to 2005 at 77 centers in the United States and Canada. The subjects of the new study had an average age of 63 and about six out of ten were men. They all had had type 2 diabetes for an average of 10 years before the study began and they were evaluated to be at increased risk for cardiovascular disease.

The subjects were asked, “How many alcoholic drinks do you consume in a typical week?” A drink, they were informed, is “a 12-ounce beer, 6 ounces of wine, or 1.5 ounces of liquor.” Their alcohol consumption was then placed into one of four levels: None, Light (1 to 7 drinks per week), Moderate (8 to 14 drinks per week), and Heavy (15 or more drinks per week). Blood pressure was similarly arranged into four categories: Normal, Elevated, Stage 1 High Blood Pressure, and Stage 2 High Blood Pressure.

The researchers determined that light alcohol use was not associated with elevated blood pressure or with Stage 1 or Stage 2 high blood pressure. Moderate drinking, however, was associated with a 79%  higher risk of elevated blood pressure (Stage 1 by 66%; Stage 2 by 62%). And heavy drinking was associated with a 91% higher risk of elevated blood pressure. Among heavy drinkers, the odds of Stage 1 high blood pressure were 149% higher and the odds of Stage 2 were 204% higher. This was what the researchers called a “dose-risk” relationship — the more alcohol a subject consumed, the higher the degree of hypertension. The researchers acknowledged that prior studies have indicated that “light and moderate alcohol consumption have beneficial effects on cardiovascular health,” but they also pointed out that there is a well-established link between hypertension and cardiovascular problems.

If there is one encouraging thing to take away from this new report, the researchers point out that alcohol consumption is a “modifiable risk factor.” Therefore doctors, they wrote, might consider “alcohol cessation counseling” for those who might need it. As the authors put it, “In light of our findings, low risk and simple lifestyle modifications to temper alcohol consumption may have the potential for clinical and public health benefits via decreased rates of hypertension. These benefits may well include, but are not limited to, decreased morbidity and mortality and lower healthcare costs.” Or, as Dr. Singleton put it, “Though light to moderate alcohol consumption may have positive effects on cardiovascular health in the general adult population, both moderate and heavy alcohol consumption appear to be independently associated with higher odds of high blood pressure among those with type 2 diabetes… People with type 2 diabetes are at higher cardiovascular risk, and our findings indicate that alcohol consumption is associated with hypertension, so limited drinking is recommended.”

Want to learn more about alcohol and diabetes? Read “Drinking and Diabetes: Seven Facts to Know,” “Diabetes, Alcohol and the Holidays” and “Beer and Health: Nine Questions Answered.”

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