Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis

Aims To analyze the dose-response relationship between average daily alcohol consumption and the risk of hypertension via systematic review and meta-analysis. Design A computer-assisted search was completed for 10 databases, followed by hand searches of relevant articles. Only studies with longitudinal design, quantitative measurement of alcohol consumption and biological measurement of outcome were included. Dose-response relationships were assessed by determining the best-fitting model via first- and second-degree fractional polynomials. Various tests for heterogeneity and publication bias were conducted. Findings A total of 12 cohort studies were identified from the literature from the United States, Japan and Korea. A linear dose-response relationship with a relative risk of 1.57 at 50 g pure alcohol per day and 2.47 at 100 g per day was seen for men. Among women, the meta-analysis indicated a more modest protective effect than reported previously: a significant protective effect was reported for consumption at or below about 5 g per day, after which a linear dose-response relationship was found with a relative risk of 1.81 at 50 g per day and of 2.81 at an average daily consumption of 100 g pure alcohol per day. Among men, Asian populations had higher risks than non-Asian populations. Conclusions The risk for hypertension increases linearly with alcohol consumption, so limiting alcohol intake should be advised for both men and women.