Kawano Y, Abe H, Takishita S, Omae T
Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Osaka, Japan.
Am J Med. 1998 Oct;105(4):307-11. doi: 10.1016/s0002-9343(98)00255-1.
Restriction of alcohol intake is widely recommended in the treatment of hypertension. However, we have observed that alcohol may have biphasic effects on blood pressure in Japanese men with hypertension.
Hypertensive men (n = 34) who habitually drank alcohol were randomly assigned to keep their drinking habits constant for 4 weeks, or to abstain (or reduce alcohol intake to a maximum of 15 mL/day) for 4 weeks in a crossover design. Amount of alcohol intake was recorded by each patient throughout the study. Office and 24-hour ambulatory blood pressure were measured at the end of both periods.
After alcohol restriction, mean (+/-SD) ethanol intake decreased from 66+/-26 mL/day to 11+/-10 mL/day. Office systolic blood pressure decreased slightly from 142+/-12 mm Hg to 139+/-11 mm Hg, and diastolic blood pressure decreased significantly from 95+/-7 mm Hg to 93+/-7 mm Hg in the low-alcohol period. Daytime systolic blood pressure fell by 3+/-9 mm Hg (P <0.05), but nighttime systolic blood pressure rose by 4+/-9 mm Hg (P <0.05) with restriction of alcohol intake. Thus, average 24-hour blood pressure did not change, although 24-hour heart rate and day-night difference in blood pressure decreased significantly in the low-alcohol period.
In Asian men with hypertension, restriction of alcohol intake reduces daytime blood pressure but not night-time or 24-hour blood pressure.
在高血压治疗中，广泛推荐限制酒精摄入。然而，我们观察到酒精对日本高血压男性的血压可能有双相作用。
习惯性饮酒的高血压男性（n = 34）采用交叉设计，随机分为两组，一组保持饮酒习惯4周，另一组戒酒（或减少酒精摄入量至最大15毫升/天）4周。在整个研究过程中，每位患者记录酒精摄入量。在两个阶段结束时测量诊室血压和24小时动态血压。
酒精限制后，平均（±标准差）乙醇摄入量从66±26毫升/天降至11±10毫升/天。在低酒精摄入期，诊室收缩压从142±12毫米汞柱略有下降至139±11毫米汞柱，舒张压从95±7毫米汞柱显著下降至93±7毫米汞柱。限制酒精摄入后，白天收缩压下降3±9毫米汞柱（P <0.05），但夜间收缩压上升4±9毫米汞柱（P <0.05）。因此，24小时平均血压没有变化，尽管在低酒精摄入期24小时心率和血压的昼夜差异显著降低。
在亚洲高血压男性中，限制酒精摄入可降低白天血压，但不能降低夜间或24小时血压。
