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The effect of alcohol dose on the development of hypertension in Asian and Western men: systematic review and meta-analysis

Korean Journal of Internal Medicine 2020년 35권 4호 p.906 ~ 916
정미향 ( Jung Mi-Hyang ) - Hallym University Chuncheon Sacred Heart Hospital Cardiovascular Center

신인순 ( Shin Ein-Soon ) - Korean Academy of Medical Sciences Research Center Research Agency for Clinical Practice Guidelines
임상현 ( Ihm Sang-Hyun ) - Catholic University College of Medicine Department of Internal Medicine
정진규 ( Jung Jin-Gyu ) - Chungnam National University School of Medicine Department of Family Medicine
이해영 ( Lee Hae-Young ) - Seoul National University Hospital Department of Internal Medicine
김철호 ( Kim Cheol-Ho ) - Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: There are inconsistencies in the effects of low to moderate dose alcohol consumption on the development of hypertension in adult men. We hypothesized that a region-specific effect might participate in this heterogeneity.

Methods: We conducted a systematic review and meta-analysis to evaluate the effect of alcohol dose on hypertension incidence using contemporary data through December 2017. Subjects were categorized according to their level of alcohol consumption as non-drinkers (reference) and low- (0.01 to 20.0 g/day), moderate- (20.1 to 40.0 g/day), moderate- to high- (40.1 to 60.0 g/day), and high-dose (> 60.0 g/day) drinkers. We defined hypertension as a blood pressure ≥ 140/90 mmHg and/or the use of anti- hypertensive drugs.

Results: In total, 11 articles (seven Asian and four Western) were selected for our analysis. Among Asian men, a significantly elevated risk was observed even in the low alcohol dose group in comparison with the group with no alcohol consumption, and the risk increased in a dose-dependent manner (pooled relative risks [95% confidence intervals (CI)]: 1.25 [1.13 to 1.38], 1.48 [1.27 to 1.72], 1.75 [1.43 to 2.15], and 1.78 [1.51 to 2.09]). Among Western men, a similar dose-response relationship was noted in general (p for subgroup difference > 0.1), but a significantly elevated risk was evident only in the high-dose group (pooled relative risks [95% CI]: 1.22 [0.85 to 1.74], 1.57 [0.90 to 2.75], 1.47 [0.44 to 4.91], and 1.49 [1.02 to 2.18]).

Conclusions: Even low doses of alcohol can lead to the development of hypertension, particularly in Asian men. Our findings could serve as additional evidence for developing an appropriate preventive strategy in each region.

키워드

Alcohol; Hypertension; Ethnic groups; Dose-response relationship; Meta-analysis
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