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Blood pressure, insulin resistance and left ventricular function in alcoholics

Rajzer, Marek1,2; Kawecka-Jaszcz, Kalina1; Czarnecka, Danuta1; Dragan, Jacek1; Bçtkowska, Barbara1

Original article
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Objective To estimate the arterial blood pressure, left ventricular function and insulin secretion in alcoholics.

Design We examined hospitalized patients between the second and seventh day of acute alcohol withdrawal and after a month of abstinence by 24 h ambulatory blood pressure monitoring, a standard oral glucose-tolerance test with determination of insulinaemia, two-dimensional and M-mode echocardiography and pulsed-wave Doppler statistical analysis was performed using Student's t test. P < 0.05 was considered statistically significant.

Patients Fifty alcoholics aged 36.3 ± 5.4 years with a history of alcohol abuse for a mean of 12 years.

Main outcome We expected the cessation of drinking to exert an influence by lowering the blood pressure and left ventricular function with a concomitant lowering of the insulin resistance.

Results During acute alcohol withdrawal the systolic (121.6 ± 7.7 versus 115.8 ± 8.7 mmHg) and diastolic blood pressures (74.5 ± 6.3 versus 72.0 ± 7.9 mmHg) were significantly higher. The nocturnal fall in blood pressure was smaller and the variability of the blood pressure was blunted. This period was characterized by hyperinsulinaemia detected by the glucose-tolerance test [ln (SUMins) 8957 ± 0.47 versus 8558 ± 0.651] correlated to hyperdynamic circulation (cardiac index 3.38 ± 0.86 versus 3.09 ± 0.69 l/min per m2). The early : late atrial filling ratio had increased significantly after 1 month of abstinence (1.98 ± 0.43 versus 2.08 ± 0.50).

Conclusions One month of abstinence from drinking decreases the blood pressure and improves the diurnal profile of the blood pressure and the left ventricular diastolic function. Hyperinsulinaemia, which is observed during acute restriction of alcohol consumption, could be one of the causes responsible for hyperdynamic circulation.

1I Cardiac Department, School of Medicine, Jagiellonian University in Kraków, Poland.

2Requests for reprints to Dr Marek Rajzer, I Klinika Kardologii, ulica Kopernika 17, 31-501 Kraków, Poland.

Received 17 January 1997 Revised 27 June 1997 Accepted 30 June 1997

© Lippincott-Raven Publishers.