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The effects of alcohol on ambulatory blood pressure and other cardiovascular risk factors in type 2 diabetes: a randomized intervention

Mori, Trevor A.; Burke, Valerie; Zilkens, Renate R.; Hodgson, Jonathan M.; Beilin, Lawrence J.; Puddey, Ian B.

doi: 10.1097/HJH.0000000000000816
ORIGINAL PAPERS: Dietary factors
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Objective: Although prospective studies suggest light-to-moderate chronic alcohol intake protects against coronary artery disease in type 2 diabetic patients, the balance of effects on individual cardiovascular risk factors needs further assessment. We examined the effects of alcohol consumption on 24-h ambulatory blood pressure (BP) and heart rate (HR), high-density lipoprotein cholesterol, fibrinogen, C-reactive protein, homocysteine, and glycaemic control in well controlled type 2 diabetes.

Methods: Twenty-four participants aged 49–66 year were randomized to a three-period crossover study with women drinking red wine 230 ml/day (∼24 g alcohol/day) and men drinking red wine 300 ml/day (∼31 g alcohol/day), or equivalent volumes of dealcoholized red wine (DRW) or water, each for 4 weeks. Ambulatory BP and HR were monitored every 30 min for 24 h at the end of each period. Home blood glucose monitoring was carried out twice weekly throughout.

Results: Red wine increased awake SBP and DBP relative to water by 2.5 ± 1.2 /1.9 ± 0.7 mmHg (P = 0.033, P = 0.008, respectively), with a similar nonsignificant trend relative to DRW. Asleep DBP fell with red wine relative to DRW (2.0 ± 0.8 mmHg, P = 0.016) with a similar nonsignificant trend relative to water. Red wine increased 24-h, awake and asleep HR relative to water and DRW. Relative to DRW, red wine did not affect glycaemic control or any other cardiovascular risk factor.

Conclusion: In well controlled type 2 diabetic individuals 24–31 g alcohol/day (∼2–3 standard drinks) raises awake BP and 24-h HR and lowers asleep BP but does not otherwise favourably or adversely modify cardiovascular risk factors.

aSchool of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth

bCentre for Population Health Research, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia

Correspondence to Professor Ian B. Puddey, School of Medicine and Pharmacology Faculty of Medicine, Dentistry and Health Sciences Medical Research Foundation Building, GPO BOX X2213, Perth, Western Australia 6847, Australia. Tel: +61 8 92240232; fax: +61 8 92240258; e-mail: Ian.Puddey@uwa.edu.au

Abbreviations: CAD, coronary artery disease; DRW, dealcoholized red wine; GEE, generalized estimating equations; γ-GT, γ-glutamyl transpeptidase; HOMA-IR, Homeostasis Model Assessment-Insulin Resistance

Received 31 July, 2015

Revised 22 September, 2015

Accepted 2 November, 2015

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