Alcohol consumption and the incidence of hypertension - The Atherosclerosis Risk in Communities Study

A close relationship between alcohol consumption and hypertension has been established, but it is unclear whether there is a threshold level for this association. In addition, it has infrequently been studied in longitudinal studies and in black people. In a cohort study, 8334 of the Atherosclerosis Risk in Communities (ARIC) Study participants, aged 45 to 64 years at base line, who were free of hypertension and coronary heart disease had their bl ood pressures ascertained after 6 years of follow-up. Alcohol consumption w as assessed by dietary interview. The type of alcoholic beverage predominan tly consumed was defined by the source of the largest amount of ethanol con sumed. Incident hypertension was defined as a systolic blood pressure great er than or equal to 140 mm Hg or diastolic blood pressure greater than or e qual to 90 mm Hg or use of antihypertensive medication. There was an increa sed risk of hypertension in those who consumed large amounts of ethanol (gr eater than or equal to 210 g per week) compared with those who did not cons ume alcohol over the 6 years of follow-up. The adjusted odds ratios (95% co nfidence interval) were 1.2 (0.85 to 1.67) for white men, 2.02 (1.08 to 3.7 9) for white women, and 2.31 (1.11 to 4.86) for black men. Only 4 black wom en reported drinking >210 g ethanol per week. At low to moderate levels of alcohol consumption (1 to 209 g per week), the adjusted odds ratios (95% co nfidence interval) were 0.88 (0.71 to 1.08) in white men, 0.89 (0.73 to 1.0 9) in white women, 1.71 (1.11 to 2.64) in black men, and 0.88 (0.59 to 1.33 ) in black women. Systolic and diastolic blood pressures were higher in bla ck men who consumed low to moderate amounts of alcohol compared with the no nconsumers but not in the 3 other race-gender strata. Models with polynomia l terms of alcohol exposure suggested a nonlinear association in white and black men. Higher levels of consumption of all types of alcoholic beverages were associated with a higher risk of hypertension for all race-gender str ata. The consumption of alcohol in amounts greater than or equal to 210 g p er week is an independent risk factor for hypertension in free-living North American populations. The consumption of low to moderate amounts of alcoho l also appears to be associated with a higher risk of hypertension in black men.