Moreira L B, Fuchs F D, Moraes R S, Bredemeier M, Duncan B B
Department of Pharmacology, Universidade Federal do Rio Grande do Sul, Brazil.
J Hypertens. 1998 Feb;16(2):175-80. doi: 10.1097/00004872-199816020-00007.
A positive association of chronic exposure to alcoholic beverages with blood pressure and the prevalence of hypertension has been described in epidemiological surveys, but the influence of time elapsed since last ingestion in this setting was not demonstrated.
A cross-sectional, population-based survey.
In total 1089 adults from Porto Alegre, randomly selected from a population-based, multi-stage probability sample, were interviewed at home. The average daily alcohol intake of each subject was calculated taking into account the concentration of ethanol in the beverages (distilled or fermented beverages), and the time elapsed between the last ingestion of ethanol and the moment of blood pressure determination. Standardized sitting blood pressure and anthropometric parameters were collected. The magnitude and shape of the associations were analyzed considering blood pressure as a continuous variable and the prevalence of arbitrarily defined hypertension. Simple and multiple linear regression models, including models to identify nonlinear associations, with quadratic and cubic terms of the amount of alcohol consumed, were employed. Blood pressure means were compared by analysis of variance and analysis of covariance. The association between hypertension and exposure to ethanol was analyzed through logistic regression models, controlling for various potential confounders.
Positive nonlinear associations of the amount of alcohol consumed with blood pressure and the prevalence of hypertension (> or = 160/95 mmHg) were found, independent of age, years of education, smoking, and use of oral contraceptive and antihypertensive drugs. The consumption of 30 g/day ethanol was associated with increases of 1.5 and 2.3 mmHg in diastolic and systolic blood pressures, respectively, for men, and 2.1 and 3.2 mmHg, respectively, for women. The prevalence of hypertension was higher among those ingesting more than 30 g/day (odds ratio = 2.9, P < 0.01). The time elapsed between the last ingestion and blood pressure measurement was independently associated with the prevalence of hypertension. Men with last consumption of alcohol 13-23 h prior to measurement had odds of being hypertensive 2.6 (confidence interval 1.3-5.0) greater than did subjects who had consumed alcoholic beverages 24 h and more before the blood pressure determination. For men, systolic and diastolic blood pressures were lower during the first 3 h after ingestion and increased afterward. Frequency of consumption and type of beverage consumed were not independently associated with level of blood pressure.
A time-dependent association between alcohol consumption and effects on blood pressure, demonstrated in experimental studies, was found for free-living individuals selected at random.
流行病学调查已表明，长期接触酒精饮料与血压及高血压患病率呈正相关，但尚未证实上次饮酒后经过的时间在此种情况下的影响。
一项基于人群的横断面调查。
从阿雷格里港的人群中通过多阶段概率抽样随机选取1089名成年人进行家访。计算每个受试者的平均每日酒精摄入量，同时考虑饮料（蒸馏酒或发酵酒）中的乙醇浓度以及上次摄入乙醇到血压测定时刻所经过的时间。收集标准化的坐位血压和人体测量参数。将血压视为连续变量，并将任意定义的高血压患病率作为分析对象，分析关联的强度和形式。采用简单和多元线性回归模型，包括用于识别非线性关联的模型，模型中含有酒精摄入量的二次项和三次项。通过方差分析和协方差分析比较血压均值。通过逻辑回归模型分析高血压与乙醇暴露之间的关联，并控制各种潜在的混杂因素。
发现酒精摄入量与血压及高血压患病率（≥160/95 mmHg）呈正非线性关联，且不受年龄、受教育年限、吸烟、口服避孕药及降压药使用情况的影响。对于男性，每天摄入30克乙醇分别与舒张压和收缩压升高1.5 mmHg和2.3 mmHg相关，对于女性则分别升高2.1 mmHg和3.2 mmHg。每天摄入超过30克乙醇者的高血压患病率更高（比值比 = 2.9，P < 0.01）。上次摄入与血压测量之间所经过的时间与高血压患病率独立相关。在测量前13 - 23小时最后一次饮酒的男性患高血压的几率比在血压测定前24小时及更长时间饮用酒精饮料的受试者高2.6倍（置信区间1.3 - 5.0）。对于男性，摄入后最初3小时内收缩压和舒张压较低，之后升高。饮酒频率和饮用饮料类型与血压水平无独立关联。
在随机选取的自由生活个体中发现了饮酒与血压影响之间的时间依赖性关联，这在实验研究中已得到证实。
