Binge Drinking Negatively Affects Blood Pressure, Lipid Profiles

Maureen Donohue

July 05, 2018

Elevated blood pressure and total cholesterol in men aged 18 to 45 may be a sign of repeated binge drinking, according to results of a new study published in the Journal of the American Heart Association.

Binge-drinking men had higher systolic blood pressure and total cholesterol levels than did their non–binge-drinking counterparts and women, irrespective of whether the women were binge drinkers or not.

"Binge drinking is one of the biggest health dangers facing young adults, and the consequences may extend beyond a bad hangover," lead study author Mariann Piano, PhD, RN, from Vanderbilt University School of Nursing, Nashville, Tennessee, said when interviewed.

In addition to being a leading cause of accidents and accidental death in young people, binge drinking is a known risk factor for developing prehypertension, hypertension, myocardial infarction, and stroke in middle-age and older adults. However, few studies have been conducted in younger adults even though they binge drink more than any other age group, so it isn't known whether binge drinking will have similar effects in a younger cohort.

The current study investigated the association between repeated binge drinking and blood pressure, lipid profiles, and fasting glucose levels in 4710 young (18 to 30 years) and mid-adulthood (31 to 45 years) participants in the US National Health and Nutrition Examination Survey (NHANES) between 2011-2012 and 2013-2014, the most recent years for which data were available. A secondary endpoint was to determine whether response to binge drinking differs by sex.

The cohort comprised three groups: non–binge drinkers, individuals who binge drank 1 to 12 times in the past year, and those who binge drank more than 12 times in that same period. Binge drinking was defined as consuming at least five drinks in a row per episode for men and at least four drinks in a row for women.

After adjustment for diet and exercise, both groups of male binge drinkers had higher blood pressure than their non–binge-drinking counterparts. Diastolic blood pressure remained unaffected. Total cholesterol was also elevated in both groups of male binge drinkers compared with the control group.

Although the same effects were not seen in women, there are "numerous population studies from around the world that have shown a relationship" between alcohol consumption and cardiovascular health metrics in women, Richard Becker, MD, director of the University of Cincinnati Heart, Lung, and Vascular Institute, Ohio, who was not involved in the study, told theheart.org | Medscape Cardiology.

"Our study was not designed to examine potential mechanistic differences; however, we know that women are at a higher risk for heart disease after the onset of menopause," Piano said. "Perhaps the differences are related to the protective effects of estrogen on a woman's cardiovascular system," she added, noting that most of the women in the study were age 18 to 35 years.

"Additional research is needed. Until then, women should not be given a sense of false security as to the impact of binge drinking on health and wellness," Becker cautioned.

The study also examined plasma lipid levels and found that both male and female participants demonstrated unfavorable changes in their lipid profiles, including significantly higher high-density lipoprotein cholesterol (HDL-C) levels.

Binge drinking also precipitated changes in glucose levels for both sexes: Glucose blood levels were higher in binge-drinking women but lower in binge-drinking men.

Table. Blood Pressure, Lipids, and Glucose by Binge-Drinking Frequency

Binge-Drinking Frequency Systolic Blood Pressure (mm Hg) Total Cholesterol (mg/dL) HDL-C (mg/dL) LDL-C (mg/dL) Glucose (mg/dL)
Men          
  Non–binge drinkers 117.5 207.8 47.0 126.5 104.7
  Binge ≤ 1-12 times/y 119.0 217.9 50.6 121.7 100.9
  Binge > 12 times/y 121.8 215.5 52.3 134.0 102.5
Women          
  Non–binge drinkers 111.8 207.6 56.6 121.3 97.1
  Binge ≤ 1-12 times/y 112.0 207.4 59.5 128.0 102.2
  Binge >12 times/y 112.2 210.3 65.3 122.4 101.8
LDL-C = low-density lipoprotein cholesterol.

 

In an accompanying editorial, Steven Bell, PhD, University of Cambridge, United Kingdom, points out that the finding of higher blood pressure in male but not female binge drinkers is in some ways supported by a meta-analysis, published in the same issue, that "similarly found a less pronounced effect of average alcohol intake on the risk of developing hypertension in women."

He adds, however, that the present study "regrettably falls short of 'completing the puzzle' of whether this difference in association with blood pressure by sex is driven by variation in drinking pattern (ie, episodes of heavy drinking being more common in men) through having not included either adjustment for, or the formal testing of an interaction with, overall volume of alcohol consumed."

"Notwithstanding this unfortunate missed opportunity, the results of the study by Piano et al are valuable in their own right through reminding us that the drinking habits we adopt in early adulthood and middle age (a time when we are typically free from disease) correlate with premorbid indicators of cardiovascular health," Bell writes.

Becker observed that prior population-based studies failed to draw firm conclusions in this age demographic, "giving the impression that heavy or binge alcohol consumption was harmful solely in older persons."

"Cardio-metabolic health is a complex interplay of genetic and environmental factors," he said. "Alcohol is known to affect genes associated with high blood pressure, causing oxidative stress that harms the inner lining of blood vessels and 'turning on' hormonal pathways that elevate blood pressure."

Teachable Moments

Piano and colleagues note that compared with previous generations, young adults today have more drinks per binge episode — an average of six to seven drinks — and binge drink more frequently, often several times a week, and posit that this increased intensity and frequency of binge drinking may place them at greater risk for more profound rates of alcohol-related harm.

"Clinicians need to address alcohol use with young adults and have a real conversation about what binge drinking constitutes," rather than "simply state, 'Binge drinking is bad,' " Piano said. "We need to address and define what binge drinking is and explain it in terms of what a standard drink is — so young adults understand how much they are actually drinking, and that eight beers is just as harmful as eight shots of whiskey."

The finding that LDL-C levels among binge and non–binge drinkers of both sexes were above the American Heart Association–recommended target of 100 mg/dL "also highlights the need perhaps to ramp-up our heart-healthy education in this age group," Piano noted.

"Rates of hypertension in young adults are increasing and rates of hypertension awareness and control are lowest in this group," she said. "Implementing lifestyle interventions to reduce blood pressure in early adulthood may be an important strategy to prevent cardiovascular disease later in life."

Becker concurred: "Young adults need to be screened and counseled about alcohol misuse — including binge drinking — and advised on how binge drinking may affect their cardiovascular health."

"The observations [in this study] translate to 'teachable moments' for clinicians as we strive to impart knowledge that translates to healthful lifestyles," he added.

Funding for the study was provided by a National Institutes of Health grant to Piano and coauthor Shane Phillips, PhD, MPT. Bell reports having no relevant disclosures.

J Am Heart Assoc. Published online June 27, 2018. Full text, Editorial, Meta-analysis

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