King A C, Parsons O A, Bernardy N C, Lovallo W R
Behavioral Sciences Laboratories, Veterans Affairs Medical Center, Oklahoma City, Oklahoma.
Alcohol Clin Exp Res. 1994 Oct;18(5):1172-6. doi: 10.1111/j.1530-0277.1994.tb00100.x.
We have previously demonstrated that alcoholics with transitory (< 72 hr) elevations in blood pressure (BP) during withdrawal continue to show residual cardiovascular dysregulation up to 4 weeks of abstinence. The present study replicates and extends these findings. Alcoholic inpatients were divided into three subgroups (ns = 14) based on BP during the first 72 hr of withdrawal: transitory hypertensives (tHTs; BP > 160/95 mm Hg), transitory borderline hypertensives (tBHs; 140/90 < or = BP < 160/95), and normotensives (NTs; all BPs < 140/90). All patients had normal resting pressures after 72 hr of withdrawal. At 3-4 weeks postadmission, the alcoholics and 14 nonalcoholic controls (CONTs) were tested at rest and during a 5-min handgrip task. The tHTs showed an exaggerated systolic and diastolic BP response to handgrip compared with NTs and CONTs, with tBHs intermediate (ps < 0.05). Drinking history showed the tHTs had the highest reported level of alcohol consumption and severity of withdrawal symptoms (ps < 0.05). Regression analyses indicated that consumption of hard liquor was the variable most predictive of admission BPs; further, parental history of hypertension potentiated this relationship for systolic BP. Age and consumption of nicotine and caffeine were not significant predictors of admission BP. The results suggest a persistent cardiovascular dysregulation in alcoholics showing transient hypertensive withdrawal BPs. These alcoholics may be at increased risk for future alcohol-related cardiovascular disorder.
我们之前已经证明,在戒酒期间血压(BP)出现短暂(<72小时)升高的酗酒者,在戒酒长达4周的时间里,仍会表现出残留的心血管调节功能紊乱。本研究重复并扩展了这些发现。根据戒酒头72小时的血压情况,将住院酗酒患者分为三个亚组(每组n = 14):短暂高血压组(tHTs;血压>160/95 mmHg)、短暂临界高血压组(tBHs;140/90≤血压<160/95)和血压正常组(NTs;所有血压<140/90)。所有患者在戒酒72小时后静息血压均正常。入院3 - 4周后,对酗酒者和14名非酗酒对照者(CONTs)进行静息状态和5分钟握力任务测试。与NTs和CONTs相比,tHTs对手握力的收缩压和舒张压反应过度,tBHs介于两者之间(p<0.05)。饮酒史显示,tHTs报告的酒精摄入量和戒断症状严重程度最高(p<0.05)。回归分析表明,饮用烈性酒是入院血压最具预测性的变量;此外,高血压家族史增强了收缩压的这种关系。年龄、尼古丁和咖啡因摄入量不是入院血压的显著预测因素。结果表明,在出现短暂高血压戒断血压的酗酒者中存在持续的心血管调节功能紊乱。这些酗酒者未来发生酒精相关心血管疾病的风险可能会增加。