Okojie Onosetale M, Javed Faheem, Chiwome Lawman, Hamid Pousette
Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Anaesthesia, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2020 Aug 27;12(8):e10086. doi: 10.7759/cureus.10086.
Hypertension is a global public health challenge and a major cause of morbidity and mortality. Alcohol is one of the most frequently abused substances around the world. The financial implications of treating hypertension are also significant. Developing successful strategies to prevent hypertension may be as important, if not more important, than managing the disease once it arises. In this review we assess the relationship between alcohol use and hypertension development. We have searched the available literature using the PubMed database and identified studies that discussed the relationship between alcohol use and either primary or any of the common causes of secondary hypertension. We found that heavy alcohol use was almost invariably associated with increased risk of developing primary hypertension, regardless of the age or gender of the participants. The relationship between low or moderate alcohol use and hypertension is less clear and some evidence even points towards possible protective effects. The pathophysiology behind the association is incompletely understood and a number of mechanisms have been proposed. Heavy alcohol use also increases the risk of insulin resistance and obstructive sleep apnea, known causes of secondary hypertension. It has also been linked to a state of hypercortisolism, sometimes called pseudo-Cushing state. Moderate alcohol consumption may be protective against diabetes and hyperthyroidism associated with Graves' disease. Overall, public health efforts should address the issue of heavy alcohol use. There does not appear to be enough evidence to recommend abstinence to those consuming low amounts of alcohol with the aim of protecting against hypertension. We believe that the current understanding of the issue is insufficient and that more both basic science and clinical research needs to be done.
高血压是一项全球性的公共卫生挑战，也是发病和死亡的主要原因。酒精是全球最常被滥用的物质之一。治疗高血压的经济影响也很显著。制定成功的高血压预防策略可能与疾病发生后进行管理一样重要，甚至更为重要。在本综述中，我们评估饮酒与高血压发生之间的关系。我们使用PubMed数据库检索了现有文献，并确定了讨论饮酒与原发性高血压或继发性高血压任何常见病因之间关系的研究。我们发现，无论参与者的年龄或性别如何，大量饮酒几乎总是与原发性高血压发病风险增加相关。少量或适度饮酒与高血压之间的关系尚不清楚，甚至有一些证据表明可能存在保护作用。这种关联背后的病理生理学尚未完全了解，人们已经提出了多种机制。大量饮酒还会增加胰岛素抵抗和阻塞性睡眠呼吸暂停的风险，而这两者是继发性高血压的已知病因。它还与皮质醇增多症状态有关，有时被称为假性库欣状态。适度饮酒可能对与格雷夫斯病相关的糖尿病和甲状腺功能亢进具有保护作用。总体而言，公共卫生工作应解决大量饮酒的问题。似乎没有足够的证据建议少量饮酒者戒酒以预防高血压。我们认为目前对该问题的理解还不够充分，需要开展更多的基础科学和临床研究。
