Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Alcohol consumption and cardiovascular risk in hypertensives with left ventricular hypertrophy: the LIFE study

Journal of Human Hypertension volume 18, pages 381–389 (2004)Cite this article

Abstract

The Losartan Intervention For End point reduction in hypertension (LIFE) study showed superiority of losartan over atenolol for reduction of composite risk of cardiovascular death, stroke, and myocardial infarction in hypertensives with left ventricular hypertrophy. We compared hazard ratios (HR) in 4287 and 685 participants who reported intakes of 1–7 and >8 drinks/week at baseline, respectively, with those in 4216 abstainers, adjusting for gender, age, smoking, exercise, and race. Within categories, clinical baseline characteristics, numbers randomized to losartan and atenolol, and blood pressure (BP) lowering were similar on the drug regimens. Overall BP control (<140/90 mmHg) at end of follow-up was similar in the categories. Composite end point rate was lower with 1–7 (24/1000 years; HR 0.87, P<0.05) and >8 drinks/week (26/1000 years; HR 0.80, NS) than in abstainers (27/1000 years). Myocardial infarction risk was reduced in both drinking categories (HR 0.76, P<0.05 and HR 0.29, P<0.001, respectively), while stroke risk tended to increase with >8 drinks/week (HR 1.21, NS). Composite risk was significantly reduced with losartan compared to atenolol only in abstainers (HR 0.81 95% confidence interval, CI (0.68, 0.96), P<0.05), while benefits for stroke risk reduction were similar among participants consuming 1–7 drinks/week (HR 0.73, P<0.05) and abstainers (HR 0.72, P<0.01). Despite different treatment benefits, alcohol-treatment interactions were nonsignificant. In conclusion, moderate alcohol consumption does not change the marked stroke risk reduction with losartan compared to atenolol in high-risk hypertensives. Alcohol reduces the risk of myocardial infarction, while the risk of stroke tends to increase with high intake.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7

Similar content being viewed by others

References

  1. Goldberg IJ, Mosca L, Piano MR, Fisher EA . AHA Science Advisory. Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation 2001; 103: 472–475.

    Article  CAS  PubMed  Google Scholar 

  2. Corrao G et al. Alcohol and coronary heart disease: a meta-analysis. Addiction 2000; 95: 1505–1523.

    Article  CAS  PubMed  Google Scholar 

  3. Reynolds K et al. Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003; 289: 579–588.

    Article  PubMed  Google Scholar 

  4. Klatsky AL . Alcohol and hypertension. Clin Chim Acta 1996; 246: 91–105.

    Article  CAS  PubMed  Google Scholar 

  5. Fuchs FD et al. Alcohol consumption and the incidence of hypertension: The Atherosclerosis Risk in Communities Study. Hypertension 2001; 37: 1242–1250.

    Article  CAS  PubMed  Google Scholar 

  6. Dahlöf B et al. The Losartan Intervention For Endpoint reduction (LIFE) in Hypertension study: rationale, design, and methods. The LIFE Study Group. Am J Hypertens 1997; 10: 705–713.

    Article  PubMed  Google Scholar 

  7. Dahlöf B et al. Characteristics of 9194 patients with left ventricular hypertrophy: the LIFE study. Losartan Intervention For Endpoint Reduction in Hypertension. Hypertension 1998; 32: 989–997.

    Article  PubMed  Google Scholar 

  8. Kjeldsen SE et al. Lowering of blood pressure and predictors of response in patients with left ventricular hypertrophy: the LIFE study. Losartan Intervention For Endpoint. Am J Hypertens 2000; 13: 899–906.

    Article  CAS  PubMed  Google Scholar 

  9. Dahlöf B et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003.

    Article  PubMed  Google Scholar 

  10. Rimm EB, Klatsky A, Grobbee D, Stampfer MJ . Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. Br Med J 1996; 312: 731–736.

    Article  CAS  Google Scholar 

  11. Hein HO, Suadicani P, Gyntelberg F . Alcohol consumption, serum low density lipoprotein cholesterol concentration, and risk of ischaemic heart disease: six year follow up in the Copenhagen male study. Br Med J 1996; 312: 736–741.

    Article  CAS  Google Scholar 

  12. Hillbom M, Numminen H, Juvela S . Recent heavy drinking of alcohol and embolic stroke. Stroke 1999; 30: 2307–2312.

    Article  CAS  PubMed  Google Scholar 

  13. Berger K et al. Light-to-moderate alcohol consumption and risk of stroke among US male physicians. N Engl J Med 1999; 341: 1557–1564.

    Article  CAS  PubMed  Google Scholar 

  14. Leppälä JM et al. Alcohol consumption and stroke incidence in male smokers. Circulation 1999; 100: 1209–1214.

    Article  PubMed  Google Scholar 

  15. Sesso HD et al. Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men. Arch Intern Med 2000; 160: 2605–2612.

    Article  CAS  PubMed  Google Scholar 

  16. Klatsky AL . Alcohol, coronary disease, and hypertension. Annu Rev Med 1996; 47: 149–160.

    Article  CAS  PubMed  Google Scholar 

  17. Al Suwaidi J et al. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation 2000; 101: 948–954.

    Article  Google Scholar 

  18. Brasier AR, Recinos III A, Eledrisi MS . Vascular inflammation and the renin–angiotensin system. Arterioscler Thromb Vasc Biol 2002; 22: 1257–1266.

    Article  CAS  PubMed  Google Scholar 

  19. Schiffrin EL, Park JB, Intengan HD, Touyz RM . Correction of arterial structure and endothelial dysfunction in human essential hypertension by the angiotensin receptor antagonist losartan. Circulation 2000; 101: 1653–1659.

    Article  CAS  PubMed  Google Scholar 

  20. Prasad A, Halcox JP, Waclawiw MA, Quyyumi AA . Angiotensin type 1 receptor antagonism reverses abnormal coronary vasomotion in atherosclerosis. J Am Coll Cardiol 2001; 38: 1089–1095.

    Article  CAS  PubMed  Google Scholar 

  21. Zhang C, Hein TW, Wang W, Kuo L . Divergent roles of angiotensin II AT1 and AT2 receptors in modulating coronary microvascular function. Circ Res 2003; 92: 322–329.

    Article  CAS  PubMed  Google Scholar 

  22. Schieffer B et al. Expression of angiotensin II and interleukin 6 in human coronary atherosclerotic plaques: potential implications for inflammation and plaque instability. Circulation 2000; 101: 1372–1378.

    Article  CAS  PubMed  Google Scholar 

  23. Krämer C et al. Angiotensin II receptor-independent antiinflammatory and antiaggregatory properties of losartan: role of the active metabolite EXP3179. Circ Res 2002; 90: 770–776.

    Article  PubMed  Google Scholar 

  24. Puddey IB, Zilkens RR, Croft KD, Beilin LJ . Alcohol and endothelial function: a brief review. Clin Exp Pharm Physiol 2001; 28: 1020–1024.

    Article  CAS  Google Scholar 

  25. Teragawa H et al. Effect of alcohol consumption on endothelial function in men with coronary artery disease. Atherosclerosis 2002; 165: 145–152.

    Article  CAS  PubMed  Google Scholar 

  26. Matsuo S et al. Effect of red wine and ethanol on production of nitric oxide in healthy subjects. Am J Cardiol 2001; 87: 1029–1031.

    Article  CAS  PubMed  Google Scholar 

  27. Celermajer DS et al. Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults. Circulation 1993; 88: 2149–2155.

    Article  CAS  PubMed  Google Scholar 

  28. Puranik R, Celermajer DS . Smoking and endothelial function. Prog Cardiovasc Dis 2003; 45: 443–458.

    Article  CAS  PubMed  Google Scholar 

  29. Craig WY, Palomäki GE, Haddow JE . Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. Br Med J 1989; 298: 784–788.

    Article  CAS  Google Scholar 

  30. Nakanishi N et al. Alcohol consumption and risk for hypertension in middle-aged Japanese men. J Hypertens 2001; 19: 851–855.

    Article  CAS  PubMed  Google Scholar 

  31. Klatsky AL . Alcohol and cardiovascular diseases: a historical overview. Ann NY Acad Sci 2002; 957: 7–15.

    Article  PubMed  Google Scholar 

  32. Linkola J et al. Renin–aldosterone axis in ethanol intoxication and hangover. Eur J Clin Invest 1976; 6: 191–194.

    Article  CAS  PubMed  Google Scholar 

  33. Puddey IB, Vandongen R, Beilin LJ, Rouse IL . Alcohol stimulation of renin release in man: its relation to the hemodynamic, electrolyte, and sympatho-adrenal responses to drinking. J Clin Endocrinol Metab 1985; 61: 37–42.

    Article  CAS  PubMed  Google Scholar 

  34. Prichard BN, Tomlinson B . The additional properties of beta adrenoceptor blocking drugs. J Cardiovasc Pharmacol 1986; 8(Suppl 4): S1–S15.

    Article  CAS  PubMed  Google Scholar 

  35. Blumenfeld JD et al. Beta-adrenergic receptor blockade as a therapeutic approach for suppressing the renin–angiotensin–aldosterone system in normotensive and hypertensive subjects. Am J Hypertens 1999; 12: 451–459.

    Article  CAS  PubMed  Google Scholar 

  36. Rimm EB et al. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. Br Med J 1995; 310: 555–559.

    Article  CAS  Google Scholar 

  37. Perry IJ et al. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged British men. Br Med J 1995; 310: 560–564.

    Article  CAS  Google Scholar 

  38. Ajani UA et al. Alcohol consumption and risk of coronary heart disease by diabetes status. Circulation 2000; 102: 500–505.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Paulette A Lyle for her valuable administrative assistance. The trial was supported by an unrestricted grant from Merck & Co., Inc.

Author information

Authors and Affiliations

  1. Ullevaal University Hospital, Oslo, Norway

    H M Reims & S E Kjeldsen

  2. University of Michigan Hospital, Ann Arbor, MI, USA

    S E Kjeldsen & S Julius

  3. Merck Research Laboratories, West Point, PA, USA

    W E Brady

  4. Sahlgrenska University Hospital/Östra, Göteborg, Sweden

    B Dahlöf

  5. Cornell Medical Center, New York, NY, USA

    R B Devereux

  6. City Hospital, Birmingham, UK

    G Beevers

  7. Karolinska University Hospital, Stockholm, Sweden

    U de Faire

  8. Helsinki University Central Hospital, Finland

    F Fyhrquist & M S Nieminen

  9. Glostrup University Hospital, Denmark

    H Ibsen

  10. Merck Research Laboratories Scandinavia, Stockholm, Sweden

    K Kristianson

  11. Viborg Hospital, Denmark

    O Lederballe-Pedersen

  12. Umeå University, Sweden

    L H Lindholm

  13. Haukeland University Hospital, Bergen, Norway

    P Omvik

  14. University of Alabama, Birmingham, AL, USA

    S Oparil

  15. The Nordic School of Public Health, Göteborg, Sweden

    H Wedel

Authors
  1. H M Reims
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S E Kjeldsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W E Brady
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B Dahlöf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R B Devereux
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Julius
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G Beevers
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. U de Faire
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. F Fyhrquist
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. H Ibsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. K Kristianson
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. O Lederballe-Pedersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. L H Lindholm
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. M S Nieminen
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. P Omvik
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. S Oparil
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. H Wedel
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the LIFE study group

Corresponding author

Correspondence to H M Reims.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reims, H., Kjeldsen, S., Brady, W. et al. Alcohol consumption and cardiovascular risk in hypertensives with left ventricular hypertrophy: the LIFE study. J Hum Hypertens 18, 381–389 (2004). https://doi.org/10.1038/sj.jhh.1001731

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001731

Keywords

This article is cited by

Search

Advanced search

Quick links