Key result
Alcohol brief intervention linked to modest blood pressure and drinking reductions, which diminish by 5 years.
Why the study?
Does alcohol screening and brief intervention improve drinking and blood pressure outcomes in primary care patients with hypertension and unhealthy alcohol use?
Observational (n=72,979)
Does alcohol screening and brief intervention improve drinking and blood pressure outcomes in primary care patients with hypertension and unhealthy alcohol use?
Alcohol screening and brief intervention in primary care patients with hypertension and unhealthy alcohol use leads to modest but significant reductions in drinking and blood pressure at 2 years.
OBJECTIVE: Hypertension is highly prevalent in primary care. Unhealthy alcohol use can impact its management and associated cardiovascular disease risks. Alcohol screening and brief intervention (ASBI) in primary care is effective for early intervention for unhealthy use, yet its effectiveness in heterogeneous populations in real-world settings remains unclear. Using electronic health records, we emulated a pragmatic clinical trial to evaluate the effects of receiving ASBI on drinking and blood pressure (BP) outcomes among primary care patients with hypertension and unhealthy alcohol use. METHOD: This observational study identified 72,979 patients with hypertension who screened positive for unhealthy drinking between January 1, 2014, and December 31, 2017. We used a target trial framework to compare the effects of receiving ASBI (intervention) to not receiving brief intervention (comparison) on drinking (change in heavy drinking days and drinks/week) and BP outcomes (changes in diastolic and systolic BP) from baseline to 2- and 5-year follow-ups. Treatment effect estimates were obtained using inverse probability-weighted models. RESULTS: At 2 years, the intervention condition had about 0.2 fewer heavy drinking days and about 0.1 fewer drinks/week than the comparison condition. The intervention condition had an additional 0.5 mmHg and 0.7 mmHg decline in diastolic and systolic BP, and 8% and 6% higher odds of having a ≥3 mmHg reduction in diastolic and systolic BP, respectively, than the comparison condition. Between-group differences in both outcomes diminished at 5 years. CONCLUSIONS: The modest changes in drinking and BP we found contribute to the emerging evidence that brief intervention may benefit broader health outcomes at the population level.
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Sterling et al. (2025) conducted an observational in Hypertension and unhealthy alcohol use (n=72,979). Alcohol screening and brief intervention (ASBI) vs. Not receiving brief intervention was evaluated on Change in heavy drinking days, drinks/week, and changes in diastolic and systolic BP (0.5 mmHg and 0.7 mmHg additional decline in diastolic and systolic BP; 8% and 6% higher odds of ≥3 mmHg reduction). Alcohol screening and brief intervention was associated with modest reductions in drinking and blood pressure at 2 years compared to no intervention, though differences diminished at 5 years.
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