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Effects of alcohol withdrawal on blood pressure in hypertensive heavy drinkers

Soardo, Giorgioa; Donnini, Deboraa; Varutti, Rosannaa; Milocco, Carlaa; Basan, Lorenzaa; Esposito, Waltera; Casaccio, Danielea; Isola, Miriamb; Soldano, Francab; Sechi, Leonardo Aa

doi: 10.1097/01.hjh.0000239283.35562.15
Original papers: Lifestyle

Background Epidemiological investigations have demonstrated a close association between heavy alcohol consumption and hypertension. The mechanisms of this association, however, remain elusive. We studied the effects of alcohol withdrawal on blood pressure, hormonal parameters, and circulating markers of endothelial activity.

Methods In 14 hypertensive heavy alcohol consumers (> 200 g/day) who agreed to participate in a hospital withdrawal programme we monitored, for 30 days, blood pressure, plasma levels of renin, aldosterone, cortisol, endothelin, and plasminogen activator inhibitor 1 (PAI-1), and urinary levels of catecholamines. Patients in the withdrawal group were compared with eight hypertensive heavy drinkers who refused to participate in the programme and maintained regular alcohol consumption and 11 normotensive teetotalers.

Results By the third day after withdrawal, blood pressure was significantly decreased and the normalization of levels was obtained in 13 of 14 patients by the end of the study. Alcohol withdrawal significantly decreased plasma aldosterone and cortisol levels, but did not affect levels of active renin and fractionated urinary catecholamines. At baseline, plasma endothelin and PAI-1 levels were significantly higher in alcoholic individuals than in teetotalers, and after the cessation of alcohol intake decreased progressively, reaching levels different from baseline within 1 week. A significant correlation was found between changes in endothelin and PAI-1, and blood pressure variations during alcohol abstinence that remained significant only for endothelin with the multivariate approach.

Conclusion Hypertension is rapidly reversible in the majority of heavy drinkers after the withdrawal of alcohol consumption. In these patients, hypertension is associated with an increased release of endothelial factors that might contribute to the increase in blood pressure.

aDepartment of Internal Medicine, Liver Unit and Hypertension Unit, Department of Experimental and Clinical Pathology and Medicine, Italy

bInstitute of Statistics, Department of Medical and Morphological Research, University of Udine School of Medicine, Udine, Italy

Received 19 July, 2005

Revised 19 January, 2006

Accepted 23 March, 2006

Correspondence and requests for reprints to Giorgio Soardo, MD, Clinica Medica, University of Udine, Department of Experimental and Clinical Pathology and Medicine, P. le S. Maria della Misericordia, 33100 Udine, Italy Tel: +39 0432 559812; fax: +39 0432 42097; e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.