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Meta-Analysis
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Sex-Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies

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Meta-Analysis

Sex-Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies

Michael Roerecke et al. J Am Heart Assoc.

Abstract

Background: Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear.

Methods and results: We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of hypertension in people without hypertension. Random-effects meta-analyses and metaregressions were conducted. Data from 20 articles with 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were included. In people drinking 1 to 2 drinks/day (12 g of pure ethanol per drink), incidence of hypertension differed between men and women (relative riskwomen vs men=0.79; 95% confidence interval, 0.67-0.93). In men, the risk for hypertension in comparison with abstainers was relative risk=1.19 (1.07-1.31; I2=59%), 1.51 (1.30-1.76), and 1.74 (1.35-2.24) for consumption of 1 to 2, 3 to 4, and 5 or more standard drinks per day, respectively. In women, there was no increased risk for 1 to 2 drinks/day (relative risk=0.94; 0.88-1.01; I2=73%), and an increased risk for consumption beyond this level (relative risk=1.42; 1.22-1.66).

Conclusions: Any alcohol consumption was associated with an increase in the risk for hypertension in men. In women, there was no risk increase for consumption of 1 to 2 drinks/day and an increased risk for higher consumption levels. We did not find evidence for a protective effect of alcohol consumption in women, contrary to earlier meta-analyses.

Keywords: alcohol; cohort studies; hypertension; meta‐analysis; systematic review.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Incidence of hypertension in men by alcohol intake at baseline in standard drinks compared with abstainers in cohort studies, 1989–2017. 1 standard drink=12 g of pure ethanol per day. CI indicates confidence interval; RR, relative risk.
Figure 3
Figure 3
Incidence of hypertension in women by alcohol intake at baseline in standard drinks compared with abstainers in cohort studies, 1989–2017. 1 standard drink=12 g of pure ethanol per day. CI indicates confidence interval; RR, relative risk.
Figure 4
Figure 4
Incidence of hypertension in men by alcohol intake at baseline compared with abstainers using restricted cubic spline metaregression, 1989–2017, n=8 studies with at least 4 alcohol intake groups relative risk on the log scale. CI indicates confidence interval.
Figure 5
Figure 5
Incidence of hypertension in women by alcohol intake at baseline compared with abstainers using restricted cubic spline metaregression, 1989–2017, n=10 studies with at least 4 alcohol intake groups relative risk on the log scale. CI indicates confidence interval.

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