Alcohol and Alcoholism Advance Access originally published online on October 18, 2005
Alcohol and Alcoholism 2006 41(1):5-10; doi:10.1093/alcalc/agh221
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Published by Oxford University Press on behalf of the Medical Council on Alcohol.
HYPERTENSION IN EARLY ALCOHOL WITHDRAWAL IN CHRONIC ALCOHOLICS
1 Alcohol Unit, University La Sapienza, Rome, 2 Istituto Superiore di Sanità, Rome and 3 Emergency Dept., University La Sapienza, Rome, Italy
* Author to whom correspondence should be addressed at: Via G. Lanza 172, 00184, Rome. Fax: +390649972096; E-mail: mauro.ceccanti{at}uniroma1.it
(First received 4 May 2005; first review notified 11 July 2005; in final revised form 25 August 2005; accepted 20 September 2005)
Aims: Hypertension is an established risk factor in chronic alcoholics, but little is known about the relationship between blood pressure (BP), severity of their alcohol abuse, and severity of alcohol withdrawal syndrome (AWS). Method: BP was assessed daily for 18 days in a series of chronic alcoholics on early alcohol withdrawal (AW), while also assessing the severity of their AWS on the CIWA-Ar scale. Results: A sharp and sustained decrease in BP was observed after AW; at T0, BP had increased in 55% of patients, and at T18 in 21%. The variation of BP is partially explained by years of at-risk drinking and AWS severity, but other factors may play a role in hypertension in alcoholics, as a large amount of BP variation was not explained by the alcohol-abuse-related parameters that we studied. BP values were not correlated with cigarette smoking, anxiety, or depression. Hypertension found in ‘detoxified’ alcoholics (
20%) may be related to alcohol-independent hypertension or to a long-lasting alcohol-induced derangement of the BP regulating mechanisms. Further research is needed in these patients to elucidate the mechanisms of persistent hypertension and to set up a treatment protocol. At present, careful monitoring is advisable, as well as pharmacological treatment for moderate or severe hypertension; often a modification of life-style is needed which includes physical activity and possibly sodium (Na) restriction, since hypertension in detoxified alcoholics seems to be Na sensitive. Conclusion: Complete alcohol abstinence must be recommended to all hypertensive alcoholics, as AW-induced transient hypertension was found to be harmless in all our subjects, and abstinence leads to a complete recovery from hypertension in most cases.