PREVENTION AND TREATMENT OF HYPERTENSION STUDY (PATHS)

Alcohol consumption has been recognized as an important correlate of b lood pressure in many epidemiologic studies, but few interventional st udies have been conducted to examine the effect of a reduction in alco hol intake on blood pressure. Because these studies have usually inclu ded few subjects and been of short duration, the National Heart, Lung, and Blood Institute (NHLBI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the Veterans Affairs (VA) Cooperative Stud ies Program have initiated a randomized, controlled, multicenter trial to determine whether blood pressure and left ventricular mass are low ered over 6 months of alcohol moderation in nondependent moderate to h eavy drinkers (three or more drinks per day average but not alcohol de pendent) with above-average normal (80 to 89 mm Hg) and mildly hyperte nsive (90 to 99 mm Hg) levels of diastolic blood pressure, and whether a reduction in alcohol intake can be maintained for 2 years. Eligible veterans are randomized to either an alcohol reduction intervention o r a control observation group at seven clinical sites. The projected s ample size is 580 participants. Alcohol intake is assessed by self-rep ort using a retrospective diary (Chronological Drinking Record) and by various biochemical markers, including apolipoproteins, HDL cholester ol (and subfractions), and carbohydrate deficient transferrin, analyze d at a central laboratory. The alcohol intervention technique is a cog nitive-behavioral program, the intensive phase of which consists of si x counseling sessions over 3 months. Echocardiograms are obtained at b aseline and 6 months after randomization. This trial has important imp lications for both the prevention and treatment of hypertension.