The epidemiology of alcohol consumption and hypertension; With special reference to stroke

Over the past 20 years there has been increasing interest in the role of alcohol consumption as a risk factor for essential hypertension. Generally, results from clinical studies demonstrate a relationship between self-reported alcohol use and blood pressure, most notably for systolic pressure. The evidence from experimental studies is mixed, reflecting the hypothesis that alcohol may not produce a unique hypertensive response. Community study results are also not unanimous in their findings. Among working men, there does appear to be a real association, although both elevated blood pressure and alcohol use may be a function of another factor. The results from screening programs generally support the association between alcohol use and blood pressure, although the magnitude of the relationship is not large. Finally, mortaltity studies offer inconclusive evidence for a chronic effect of alcohol use on blood pressure. Since a fundamental rationale for investigating alcohol use as a risk for hypertension is that it may play a significant role in stroke, a review of the evidence associating alcohol use to stroke is presented. Research and clinical issues are raised in studying the role of alcohol consumption in both essential hypertension and stroke.