Alcohol and Hypertension

Summary Although a link between excessive alcohol consumption and hypertension was first suggested early this century, little attention was paid to this and it is only in the last decade that the association has become established. Support for the concept of alcohol as a cause of hypertension derives from (1) the demonstration in general population samples that blood pressure is significantly correlated with alcohol intake, (2) the high prevalence of hypertension in alcohol–dependent subjects which is reversible on abstinence, (3) the high frequency with which elevated MCV, serum transaminase and serum γGT levels are found in hypertensive patients and (4) the recent finding that alcohol has a direct pressor effect in such patients. There are probably at least two different mechanisms underlying alcohol–induced hypertension. In alcohol–dependent patients, hypertension is particularly common during withdrawal from alcohol and this may reflect stimulation of corticosteroid, catecholamine and vasopressin production. The direct pressor effect may be due to alcohol induced arteriolar vasoconstriction. Alcohol–induced hypertension is a common clinical problem. More emphasis should be placed on its detection, for with reduction or cessation of alcohol consumption, blood pressure will return to normal in many patients and antihypertensive drug therapy can thus be avoided.