The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Although it is well established that heavy alcohol consumption increases the risk of hypertension, little is known about the effect of a reduction of alcohol intake on blood pressure. We aimed to assess the effect of a reduction in alcohol consumption on change in blood pressure stratified by initial amount of alcohol consumption and sex in adults. METHODS: In this systematic review and meta-analysis, we searched MedLine, Embase, CENTRAL, and ClinicalTrials.gov from database inception up to July 13, 2016, for trials investigating the effect of a change of alcohol consumption on blood pressure in adults using keywords and MeSH terms related to alcohol consumption, blood pressure, and clinical trials, with no language restrictions. We also searched reference lists of identified articles and published meta-analyses and reviews. We included full-text articles with original human trial data for the effect of a change of alcohol consumption on blood pressure in adults, which reported a quantifiable change in average alcohol consumption that lasted at least 7 days and a corresponding change in blood pressure. We extracted data from published reports. We did random-effects meta-analyses stratified by amount of alcohol intake at baseline. All meta-analyses were done with Stata (version 14.1). For the UK, we modelled the effect of a reduction of alcohol consumption for 50% of the population drinking more than two standard drinks per day (ie, 12 g pure alcohol per drink). FINDINGS: 36 trials with 2865 participants (2464 men and 401 women) were included. In people who drank two or fewer drinks per day, a reduction in alcohol was not associated with a significant reduction in blood pressure; however, in people who drank more than two drinks per day, a reduction in alcohol intake was associated with increased blood pressure reduction. Reduction in systolic blood pressure (mean difference -5·50 mm Hg, 95% CI -6·70 to -4·30) and diastolic blood pressure (-3·97, -4·70 to -3·25) was strongest in participants who drank six or more drinks per day if they reduced their intake by about 50%. For the UK, the results would translate into more than 7000 inpatient hospitalisations and 678 cardiovascular deaths prevented every year. INTERPRETATION: Reducing alcohol intake lowers blood pressure in a dose-dependent manner with an apparent threshold effect. Implementation of effective alcohol interventions in people who drink more than two drinks per day would reduce the disease burden from both alcohol consumption and hypertension, and should be prioritised in countries with substantial alcohol-attributable risk. FUNDING: National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).
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- Findingown data
After accounting for baseline alcohol intake, little heterogeneity remained in the diastolic blood pressure analysis (I2=15.4%).
“and there was little heterogeneity left to explain (I2=15·4%).”
Quote in the paperNot a substantial claim - Findingown data
For people consuming three drinks daily, reducing to near abstinence produced a significant systolic blood pressure change (MD −1.18 mm Hg, 95% CI −2.32 to −0.04).
“A reduction of alcohol consumption to near abstinence for people who drank three drinks per day resulted in a significant change in systolic blood pressure (MD −1·18, 95% CI −2·32 to −0·04) and diastolic blood pressure (−1·09, −1·61 to −0·57).”
Quote in the paperSubstantial claim - Findingown data
The review included 36 trials with 2865 participants, comprising 2464 men and 401 women.
“36 trials with 2865 participants (2464 men and 401 women) were included.”
Quote in the paperNot a substantial claim - Findingown data
Excluding each trial one at a time produced no meaningful differences in effects.
“Leaving each trial out of the analysis one at a time showed no meaningful differences in effects (appendix pp 8–11).”
Quote in the paperNot a substantial claim - Findingown data
Baseline alcohol intake strongly influenced the size of systolic blood pressure reduction (β = −0.91 mm Hg per additional drink per day; p<0.0001).
“the amount of alcohol intake from which consumption was reduced (mean alcohol at baseline) showed a strong effect on the magnitude of the blood pressure reduction (β = −0·91 mm Hg; p<0·0001 for systolic blood pressure; β = −0·75 mm Hg; p<0·0001 for diastolic blood pressure, per one drink per day).”
Quote in the paperSubstantial claim
- Findingown data
Adding trial duration and blood pressure measurement method to the model increased explained variance only slightly (3%).
“However, the improvement of explained variance was small (3%).”
Quote in the paperNot a substantial claim - Findingown data
The strong dose-response association between baseline alcohol intake and blood pressure reduction appeared in every subgroup stratum.
“Findings of subgroup analyses showed that the strong dose-response association for amount of alcohol intake at baseline was found in all strata (table 2).”
Quote in the paperNot a substantial claim - Findingown data
Removing three trials in which the control group reduced alcohol consumption had almost no impact on the findings.
“Exclusion of three trials24,26,33 in which the control group reduced its alcohol consumption had almost no effect on the findings.”
Quote in the paperNot a substantial claim - Findingown data
No trial characteristic other than baseline alcohol intake was significantly associated with diastolic blood pressure change.
“No trial characteristics other than alcohol at baseline were significantly associated with diastolic blood pressure change”
Quote in the paperNot a substantial claim - Findingown data
Only one trial examined people with hypertension who consumed three or fewer drinks per day.
“Similarly, there was only one trial in people with hypertension who consumed three or fewer drinks per day.”
Quote in the paperSubstantial claim - Findingown data
Healthy participants displayed the same dose-response association for initial alcohol intake as other subgroups.
“Similarly, healthy participants showed the same dose-response association for initial alcohol intake reported in all other subgroup analyses.”
Quote in the paperNot a substantial claim - Findingown data
In participants who consumed at least six drinks daily and cut intake by roughly half, diastolic blood pressure decreased by 3.97 mm Hg (95% CI 4.70 to 3.25).
“Reduction in systolic blood pressure (mean difference −5·50 mm Hg, 95% CI −6·70 to −4·30) and diastolic blood pressure (−3·97, −4·70 to −3·25) was strongest in participants who drank six or more drinks per day if they reduced their intake by about 50%.”
Quote in the paperSubstantial claim - Findingown data
Across all trials, reducing alcohol consumption lowered diastolic blood pressure by 2.00 mm Hg (95% CI 2.65 to 1.35).
“and −2·00 (−2·65 to −1·35) for diastolic blood pressure”
Quote in the paperSubstantial claim - Findingown data
Baseline alcohol intake strongly influenced the size of diastolic blood pressure reduction (β = −0.75 mm Hg per additional drink per day; p<0.0001).
“the amount of alcohol intake from which consumption was reduced (mean alcohol at baseline) showed a strong effect on the magnitude of the blood pressure reduction (β = −0·91 mm Hg; p<0·0001 for systolic blood pressure; β = −0·75 mm Hg; p<0·0001 for diastolic blood pressure, per one drink per day).”
Quote in the paperSubstantial claim - Findingown data
Baseline alcohol intake accounted for 93.4% of the between-study variance in diastolic blood pressure.
“Alcohol intake at baseline explained 75·4% of the between-study variance in systolic blood pressure, and 93·4% in diastolic blood pressure.”
Quote in the paperSubstantial claim - Findingown data
The high-quality trials were consistent with a dose-response association seen in all subgroup analyses.
“The high quality trials as defined by our criteria were consistent with a dose-response association recorded in all subgroup analyses.”
Quote in the paperSubstantial claim - Findingown data
In multivariate meta-regression controlling for baseline alcohol, 24-hour blood pressure measurement versus office measurement was associated with greater systolic blood pressure reduction (β −1.14 mm Hg; p=0.043).
“length of the trial (β −0·036 mm Hg per week; p=0·042) and blood pressure assessment method (24 h vs office, β −1·14 mm Hg; p=0·043) were significantly associated with blood pressure reduction in multivariate meta-regression models when alcohol at baseline was controlled for.”
Quote in the paperNot a substantial claim - Findingown data
For individuals consuming two or fewer drinks daily, lowering alcohol intake did not significantly reduce blood pressure.
“In people who drank two or fewer drinks per day, a reduction in alcohol was not associated with a significant reduction in blood pressure”
Quote in the paperSubstantial claim - Findingown data
In multivariate meta-regression controlling for baseline alcohol, longer trial duration was associated with greater systolic blood pressure reduction (β −0.036 mm Hg per week; p=0.042).
“length of the trial (β −0·036 mm Hg per week; p=0·042) and blood pressure assessment method (24 h vs office, β −1·14 mm Hg; p=0·043) were significantly associated with blood pressure reduction in multivariate meta-regression models when alcohol at baseline was controlled for.”
Quote in the paperNot a substantial claim - Findingown data
For people consuming three drinks daily, reducing to near abstinence produced a significant diastolic blood pressure change (MD −1.09 mm Hg, 95% CI −1.61 to −0.57).
“A reduction of alcohol consumption to near abstinence for people who drank three drinks per day resulted in a significant change in systolic blood pressure (MD −1·18, 95% CI −2·32 to −0·04) and diastolic blood pressure (−1·09, −1·61 to −0·57).”
Quote in the paperSubstantial claim - Findingown data
Baseline alcohol intake accounted for 75.4% of the between-study variance in systolic blood pressure.
“Alcohol intake at baseline explained 75·4% of the between-study variance in systolic blood pressure, and 93·4% in diastolic blood pressure.”
Quote in the paperSubstantial claim - Findingown data
In participants who consumed at least six drinks daily and cut intake by roughly half, systolic blood pressure decreased by 5.50 mm Hg (95% CI 6.70 to 4.30).
“Reduction in systolic blood pressure (mean difference −5·50 mm Hg, 95% CI −6·70 to −4·30) and diastolic blood pressure (−3·97, −4·70 to −3·25) was strongest in participants who drank six or more drinks per day if they reduced their intake by about 50%.”
Quote in the paperSubstantial claim - Findingown data
Between-study heterogeneity was substantial, with I2 values of 82.0% for systolic and 79.5% for diastolic blood pressure.
“with substantial between-study heterogeneity (I2 82·0% and 79·5%, respectively).”
Quote in the paperSubstantial claim - Findingown data
For individuals consuming more than two drinks daily, lowering alcohol intake was linked to a larger fall in blood pressure.
“however, in people who drank more than two drinks per day, a reduction in alcohol intake was associated with increased blood pressure reduction.”
Quote in the paperSubstantial claim - Findingown data
Across all trials, reducing alcohol consumption lowered systolic blood pressure by 3.13 mm Hg (95% CI 3.93 to 2.32).
“The overall effect of a reduction of alcohol consumption across all trials was −3·13 mm Hg (95% CI −3·93 to −2·32) for systolic blood pressure”
Quote in the paperSubstantial claim - Findingown data
There was no evidence of small-study effects or publication bias (Egger's test p=0.10 for systolic and p=0.47 for diastolic blood pressure).
“We found no evidence for small-study effects or publication bias (Egger’s test; p=0·10 and 0·47 for systolic blood pressure and diastolic blood pressure, respectively).”
Quote in the paperNot a substantial claim - Study design and conductnone given
Increasing attrition in longer trials suggests a possible risk of bias.
“Nevertheless, increasing attrition in longer trials suggests a possible risk of bias”
Quote in the paperNot a substantial claim - Premisecitation
The physiological mechanisms by which alcohol affects blood pressure and hypertension remain unknown.
“Despite the evidence from randomised trial data presented here and also from observational data,59 the physiological mechanisms for alcohol’s effect on blood pressure and hypertension are still unknown.60”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [59] Taylor, 2009, Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis, Addiction source
Not checked in the free run.
- cites [60] Klatsky, 2008, Alcohol and hypertension: a review, J Am Soc Hypertens source
Not checked in the free run.
- Study design and conductown data
Because only three trials reported results for women, confidence in the pooled effect estimates is lower.
“Because only three trials reported results for women,28,50,53 we have less confidence in the pooled effect estimates.”
Quote in the paperSubstantial claim - Interpretationown data
The blood pressure benefit of reduced alcohol intake persists as long as lower consumption is maintained.
“There was almost no difference from the first measurement to the last, which suggests that the effect of a reduction in alcohol consumption on blood pressure is sustained when lower alcohol consumption is sustained.”
Quote in the paperSubstantial claim - Premisecitation
Only about half of hypertension guidelines worldwide recommend reducing alcohol consumption to lower raised blood pressure.
“yet only about half of hypertension guidelines worldwide recommend a reduction in alcohol consumption to reduce raised blood pressure.62”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [62] Chalmers, 2013, Global survey of current practice in management of hypertension as reported by societies affiliated with the International Society of Hypertension, J Hypertens source
Not checked in the free run.
- Interpretationreasoning
For the UK, the modelled blood pressure reduction would prevent 7272 inpatient hospitalisations and 678 cardiovascular deaths each year.
“This reduction of blood pressure translates into marked clinical effects, with 7272 inpatient hospitalisations (1207 in women and 6064 in men) and 678 cardiovascular disease (CVD) deaths avoided every year (125 in women, 552 in men), mainly in ischaemic heart disease”
Quote in the paperSubstantial claim- The authors state this as an assumption: In the UK population modelling, lower alcohol consumption persists for at least one year.
- The authors state this as an assumption: There is no lag time between reduced alcohol consumption and effects on cardiovascular disease outcomes.
- The authors state this as an assumption: The modelled intervention to reduce alcohol consumption covers 50% of the population drinking more than two standard drinks per day.
- Study design and conductnone given
Twelve studies from 11 trials were judged to be of high technical quality.
“We judged 12 studies from 11 trials to be of high technical quality.”
Quote in the paperNot a substantial claim - Study design and conductreasoning
The GRADE quality of evidence for a dose-response association was high, based on consistency, precision, magnitude of effects from randomised controlled trials, and high clinical importance in heavy drinkers.
“Using the GRADE approach, we rate the quality of the evidence for a dose-response association as high because of the consistency, precision, and magnitude of the effects based on randomised controlled trial data, with high clinical importance in heavy drinkers.”
Quote in the paperSubstantial claim - Interpretationreasoning
Drinking two or fewer drinks per day does not raise blood pressure.
“People drinking two drinks or fewer per day did not have a significant reduction in blood pressure when they reduced their alcohol consumption to near abstinence, suggesting that this amount of alcohol intake does not increase blood pressure.”
Quote in the paperSubstantial claim - Interpretationown data
The more a person drinks above two drinks per day, the greater the blood pressure reduction when intake is lowered.
“However, the more people drink beyond this level, the higher the subsequent reduction in blood pressure.”
Quote in the paperSubstantial claim - Premisecitation
Men and women metabolise alcohol differently due to differences in body fat distribution, body size, and alcohol solubility.
“Women and men metabolise alcohol differently because of differences in body fat distribution, body size, and alcohol solubility.7”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Frezza, 1990, High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism, N Engl J Med source
Not checked in the free run.
- Interpretationreasoning
The consistency of the dose-response association across subgroups defined by cardiovascular risk, study design, and study quality suggests the findings have high generalisability.
“Moreover, the consistency of the dose-response association subgroups defined by CVD risk, study design, and study quality suggests that our findings should have high generalisability.”
Quote in the paperSubstantial claim - Interpretationreasoning
In the UK model, the proportion of people with systolic blood pressure above 140 mm Hg was estimated to fall by 4.4% in men and 1.2% in women, mostly in mid-adulthood.
“Overall, the proportion of people with systolic blood pressure higher than 140 mm Hg was estimated to fall by 4·4% for men, and 1·2% for women, with most of the effect emerging in mid-adulthood.”
Quote in the paperSubstantial claim- The authors state this as an assumption: In the UK population modelling, lower alcohol consumption persists for at least one year.
- The authors state this as an assumption: There is no lag time between reduced alcohol consumption and effects on cardiovascular disease outcomes.
- The authors state this as an assumption: The modelled intervention to reduce alcohol consumption covers 50% of the population drinking more than two standard drinks per day.
- Premisecitation
A previous review more than 15 years earlier found an average systolic blood pressure reduction of −3.31 mm Hg (95% CI −4.10 to −2.52) when alcohol consumption was reduced, without sex-specific results.
“The last review6 of the effects of alcohol reduction on blood pressure was done more than 15 years ago and showed an average systolic blood pressure reduction of −3·31 mm Hg (95% CI −4·10 to −2·52) when alcohol consumption was reduced; results were not presented by sex.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [6] Xin, 2001, Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials, Hypertension source
Not checked in the free run.
- Interpretationcitation
Reducing alcohol consumption has additional effects on disease burden that were not modelled here.
“Aside from the substantial estimated effect on CVD mortality and morbidity caused by hypertension, a reduction of alcohol consumption has additional effects on disease burden63 not modelled here.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [63] Rehm, 2013, Reduction of drinking in problem drinkers and all-cause mortality, Alcohol Alcohol source
Not checked in the free run.
- May combine two claims. 12
- Classified as probably not a substantial claim. 10
May combine two claims.
Findingown dataAmong 27 trials reporting weight change during alcohol reduction, only ten found a significant change (between −0.3 and −1.7 kg); the rest found no significant or no change.
“Of 27 trials that reported on weight change during alcohol reduction, only ten reported a significant change (between −0·3 and −1·7 kg), the other trials reported no significant or no change in weight.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe blood pressure effect of reducing alcohol was similar in men and women, though data for women were sparse.
“Results were similar for men and women; however, data for women were sparse.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe weighted mean reduction in alcohol consumption was −15, −30, −40, and −32 g per day for participants consuming two or fewer, three, four to five, and six or more drinks per day, respectively.
“The weighted mean reduction in alcohol consumption from baseline was −15, −30, −40, and −32 g per day in participants consuming two or fewer, three, four to five, and six or more drinks per day at baseline, respectively.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataThe weighted mean baseline alcohol consumption was 15, 30, 49, and 76 g per day for participants consuming two or fewer, three, four to five, and six or more drinks per day, respectively.
“The weighted mean alcohol consumption at baseline was 15, 30, 49, and 76 g per day in participants consuming two or fewer, three, four to five, and six or more drinks per day at baseline.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingreasoningThe dose-response association was present in healthy participants and in those with hypertension or other cardiovascular risk factors.
“The dose-response association was evident in healthy participants and people with hypertension or other CVD risk factors.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataFor people drinking five or fewer drinks per day, baseline alcohol was mostly compared with abstinence or near abstinence; for those drinking six or more, the mean reduction was about 50%.
“Thus, alcohol at baseline was mostly compared with abstinence or near abstinence for people who drank five or fewer drinks per day at baseline, and about 50% mean reduction in alcohol intake for people who drank six or more drinks per day at baseline.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe corresponding author had full access to all data and final responsibility for submission.
“The corresponding author had full access to all of the data and the final responsibility to submit for publication.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationPrice increases and availability restrictions are effective and cost-effective population-level interventions to reduce harmful alcohol consumption.
“In terms of alcohol policy, price increase and availability restrictions have been shown to be effective and cost-effective interventions to reduce harmful alcohol consumption on a population level.67”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [67] Babor, 2010
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningEffective alcohol interventions for people drinking more than two drinks per day would substantially reduce the disease burden from alcohol and hypertension.
“Implementation of effective alcohol interventions in people who drink more than two drinks per day would reduce the disease burden from both alcohol consumption and hypertension, and should be prioritised in countries with substantial alcohol-attributable risk.”
Quote in the paperSubstantial claim- The authors state this as an assumption: In the UK population modelling, lower alcohol consumption persists for at least one year.
- The authors state this as an assumption: There is no lag time between reduced alcohol consumption and effects on cardiovascular disease outcomes.
- The authors state this as an assumption: The modelled intervention to reduce alcohol consumption covers 50% of the population drinking more than two standard drinks per day.
May combine two claims.
Study design and conductown dataThe Cochrane Risk of Bias assessment indicated potential high risk from masking and allocation concealment, with low or unclear risk in most other domains.
“The Cochrane Risk of Bias method showed potential high risk of bias from masking and allocation concealment, and low or unclear risk in most other domains (appendix p 12).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAwareness and treatment of hypertension are not optimal and may be especially important in heavy drinkers.
“Similarly, awareness and treatment for hypertension are not optimal,65 and might be especially important in heavy drinkers.66”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [65] Joffres, 2013, Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study, BMJ Open source
Not checked in the free run.
- cites [66] Org, 2011, HYPEST study: profile of hypertensive patients in Estonia, BMC Cardiovasc Disord source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe funder had no role in study design, data collection, data analysis, data interpretation, or writing the report.
“The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenMasking and allocation concealment are almost impossible in trials of lifestyle changes such as alcohol consumption.
“With regard to risk of bias, masking and allocation concealment are almost impossible to achieve in trials investigating lifestyle changes such as alcohol consumption.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataReducing alcohol consumption lowers blood pressure in a dose-dependent way, with an apparent threshold at two drinks per day.
“A reduction in alcohol consumption reduced blood pressure in a dose-dependent manner with an apparent threshold effect at two drinks per day.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe study followed PRISMA guidelines.
“following the PRISMA guidelines,8”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [8] Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, Ann Intern Med source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataThe study used random-effects meta-analyses stratified by baseline alcohol intake.
“We did random-effects meta-analyses stratified by amount of alcohol intake at baseline.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataThe search covered MedLine, Embase, CENTRAL, and ClinicalTrials.gov from inception to July 13, 2016, with no language restrictions.
“we systematically searched MedLine, Embase, the Cochrane library (CENTRAL), and ClinicalTrials.gov, from inception to July 13, 2016”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study performed three complementary quality and risk-of-bias analyses.
“Recognising that quality score use in meta-analyses remains controversial,12,13 we did three complementary quality and risk of bias analyses.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [12] Greenland, 2001, On the bias produced by quality scores in meta-analysis, and a hierarchical view of proposed solutions, Biostatistics source
Not checked in the free run.
- cites [13] Herbison, 2006, Adjustment of meta-analyses on the basis of quality scores should be abandoned, J Clin Epidemiol source
Not checked in the free run.
The authors state this as an assumption.
In the UK population modelling, lower alcohol consumption persists for at least one year.
“assuming persistence of lower alcohol consumption within 1 year, and no lag time of effects on CVD outcomes.”
The authors state this as an assumption.
There is no lag time between reduced alcohol consumption and effects on cardiovascular disease outcomes.
“assuming persistence of lower alcohol consumption within 1 year, and no lag time of effects on CVD outcomes.”
The authors state this as an assumption.
The modelled intervention to reduce alcohol consumption covers 50% of the population drinking more than two standard drinks per day.
“assuming a coverage rate of 50% (ie, an intervention to reduce alcohol consumption for 50% of the population drinking more than two standard drinks per day)”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A positive linear association exists between alcohol consumption, blood pressure, the prevalence of hypertension, and CVD risk.
“Positive linear association exists between alcohol consumption, blood pressure, the prevalence of hypertension, and CVD risk. 51”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [51]
The Discussion reports a dose-dependent relationship between alcohol reduction and blood pressure, but describes an apparent threshold at two drinks per day—not a positive linear association across all consumption levels. The Results also model reductions in the proportion of people with high systolic blood pressure and in CVD deaths after reduced drinking; they do not establish a linear relationship for hypertension prevalence or CVD risk. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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Umbrella review and Delphi study on modifiable factors for dementia risk reduction
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“31,57,58 Finally, although the effects of smoking on BP are only modest, 59 all people with hypertension should be counselled to stop smoking to reduce its associated risks of cardiovascular morbidity and death.”
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A priori dietary patterns and blood pressure in the EPIC Florence cohort: A cross-sectional study
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- Authors
- Roerecke, M., Kaczorowski, J., Tobe, S. W., Gmel, G., Hasan, O. S. M., & Rehm, J.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Université de Montréal (CA)
- University of Toronto (CA)
- Corresponding author
- Roerecke, Michael
- Venue
- The Lancet Public Health
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 2
- Issue
- 2
- Pages
- e108-e120
- ISSN
- 2468-2667 (ISSN-L)
- PMC
- PMC6118407
- OpenAlex
- W2586294530
- Cited by
- 552
- References
- 69
- Citations by year
- 2026: 47 · 2025: 64 · 2024: 60 · 2023: 64 · 2022: 96 · 2021: 69 · 2020: 62 · 2019: 45 · 2018: 32 · 2017: 12 · 2012: 1
- FWCI
- 6.60
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Public Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (R21AA023521)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol consumption reduction, alcohol consumption, blood pressure, hypertension, systolic blood pressure, diastolic blood pressure, dose-response relationship, threshold effects, heavy drinking, sex differences, alcohol interventions, cardiovascular disease prevention, hospitalization prevention, cardiovascular mortality, alcohol-related disease burden, adults, randomized controlled trials
- MeSH terms
- Alcohol Drinking, Blood Pressure, Humans, Hypertension, Randomized Controlled Trials as Topic
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