Effectiveness of advice to reduce alcohol consumption in hypertensive patients.

Abstract

The relation between alcohol consumption and blood pressure is well recognized, and advice to reduce alcohol plays an important part in the management of hypertensive patients. We have evaluated the effectiveness of this advice in a randomized, controlled, single-blind clinical study. After a 2-week run-in period, hypertensive men regularly consuming more than 20 units/wk (1 unit = 10 g) of alcohol were randomly assigned either to the "advice" or control group and were seen at 2-week intervals over an 8-week study period. The outcome measures were: reported alcohol consumption (1-week retrospective diary), markers of alcohol consumption (serum gamma-glutamyl transpeptidase, aspartate aminotransferase, uric acid, mean corpuscular volume), and blood pressure (sitting and standing). Over 18 months, 67 men who drank more than 20 units/wk of alcohol were seen. Twenty-six either were excluded, refused to participate, or dropped out due to nonattendance. Forty-one patients completed the study. After intervention, reported alcohol consumption fell from 60 units/wk to around 30 units/wk in the advice group, whereas it remained between 50 and 60 units/wk in the control group (analysis of variance [ANOVA] F = 7.1, p less than 0.05). This was accompanied by falls in gamma-glutamyl transpeptidase (20.9%) and aspartate aminotransferase (18.1%), but no significant changes were seen in the control group. Standing diastolic blood pressure fell significantly in the advice group (from 101.5 mm Hg to 96.3 mm Hg) compared with the control group (ANOVA F = 4.8, p less than 0.05). The results suggest that advice to reduce alcohol consumption is a useful form of treatment for hypertensive patients who drink excessively.