Combined Effect of Hypertension and Alcohol Consumption on the Risk of Death (27‑Year Cohort Prospective Study).

Aim      To study the effect of arterial hypertension (AH) in combination with frequent alcohol consumption on the formation of risk for cardiovascular death and all-cause death according to results of a 27-year prospective cohort study.Material and methods  This 27‑year prospective cohort study of an unorganized population of the Tomsk city (1546 people aged 20-59 years, including 630 men and 916 women) investigated AH prevalence and alcohol consumption (1988-1991) and analyzed the predictive significance of the effect of AH in combination with frequent alcohol consumption on the formation of risk for all-cause and cardiovascular death. AH was diagnosed at blood pressure ≥140 / 90 mm Hg. Frequent alcohol users were defined as those who consumed alcohol more than once a week.Results The combination of AH and frequent alcohol consumption increased the risk of all-cause death 4.1 times compared to that for persons without these risk factors (p<0.001). This was true for all age groups of the total cohort (higher relative risk, RR, was observed for persons aged 20-39 years) and for men (except for the group aged 40-59 years). RR of cardiovascular death was 5.3 (p<0.001) for frequent alcohol users with AH. It was established that frequent alcohol consumption additionally increased RR of all-cause death for persons with AH (RR 1.89; p<0.05) primarily at the expense of persons aged 20-39 years. Prediction of 27‑year survival for frequent alcohol users with AH was 35.3 %.Conclusion      A combination of AH with frequent alcohol consumption considerably increases the risk of all-cause and cardiovascular death. Frequent alcohol consumption significantly impairs the prediction of 27-year survival for persons with AH by additionally (1.9 times) increasing the risk of all-cause death. Binary AH combinations with frequent alcohol consumption exert a more pronounced adverse effect on young men and women.