Alkol Tüketiminin Hipertansiyon Üzerine Etkileri

Non farmakolojik tedavi ve yaşam şekli değişiklikleri ile hipertansiyonun önlenmesi ve kan basıncının düşürülmesi, kardiyovasküler hastalıklarla ilişkili morbidite ve mortaliteyi azaltma ve tedavi harcamalarını düşürmede önemli bir rol oynayabilir. Alkol kullanımının azaltılması JNC VII raporunda önerilen yaşam tarzı değişikliklerinden birisidir. Aşırı miktarda alkol tüketimi hem normotansif, hem de hipertansif bireylerde kan basıncında yükselmeye neden olur. Aynı zamanda alkol antihipertansif ilaç tedavisine direnç oluşturabilir. Alkolün kan basıncı üzerine etkisi alkolün türünden çok, alkol miktarına bağlıdır. Kalp hastalığı açısından bakılacak olursa hafif-ılımlı alkol kullanımı her ne kadar kan basıncı artışına eğilim oluştursa da yüksek dansiteli lipoprotein kolesterolü artırması, fibrojeni ve platelet agregasyonunu azaltması ve antioksidan sistemler üzerindeki olumlu etkileri ile azalmış koroner hastalık ve iskemik inme riski ile beraberdir. Bununla birlikte tüketilen alkol miktarı arttıkça kan basıncında yükselme, hemorajik ve iskemik inme, alkolle ilişkili kardiyomyopati, aritmi ve ani kardiyak ölüm riski artmaktadır. Bu nedenle hipertansiyon saptanan kişilerde ilaç tedavisinin dışında yapılması gerekenlerden birisi alkolün bırakılması veya azaltılması olmalıdır. Alkol alımının azaltılması ile sistolik ve diyastolik kan basınçlarındaki net azalma arasında belirgin pozitif ilişki olduğu saptanmıştır. Alkol tüketiminin azaltılması sistolik kan basıncında yaklaşık 2-4 mmHg bir azalma sağlamaktadır. Bu nedenle erkeklerde günde 1-2 içki, kadınlar ve çok zayıf kişilerde 1 içkiye kadar miktarlar optimal gözükmektedir. Alkol kullanan kişilerde anahtar sözcüğün ılımlılık, aşırıya kaçmamak olduğu unutulmamalıdır.

Anahtar Kelimeler:

Alkol, Hipertansiyon, Kardiyovasküler Hastalık

Effects of Alcohol Consumption on Hypertension

Prevention of hypertension and lowering blood pressure with non-pharmacological treatment and lifestyle changes may reduce cardiovascular morbidity and mortality associated with alcohol while they also play an important role in reducing the cost of medical treatment. Reduction of alcohol consumption is one of the recommended lifestyle changes in the JNC VII report. Excessive amounts of alcohol consumption leads to an increase in blood pressure in both normotensive and hypertensive individuals. At the same time, alcohol can lead to resistance to antihypertensive drug treatment. Effects of alcohol on blood pressure is depent on the amount of alcohol rather than the type of alcohol. As far as heart diseases are concerned, mild-to-moderate alcohol consumption, despite its tendency to increase blood pressure, is associated with decreased risk of coronary artery diseases and ischemic stroke by way of elevating high-density lipoprotein cholesterol levels, reducing fibrinogen and platelet aggregation, and producing positive effects on antioxidants systems. However, increased alcohol consumption is accompanied by increased blood pressure, hemorrhagic and ischemic strokes, alcohol-induced cardiomyopathy, arrhythmia, and sudden cardiac death. Therefore, people with hypertension should avoid or reduce alcohol consumption in addition to drug treatment. A positive relationship has been detected between decreasing alcohol consumption and systolic and diastolic blood pressures. Reducing alcohol consumption provides a 2-4 mmHg reduction in systolic blood pressure levels. For this reason, 1-2 drinks per day for men and up to one drink for women and people with poor health seem to be optimal amounts. People who use alcohol should keep in mind that moderation and unexcessive consumption are the key words in avoiding alcohol related medical conditions.Key Words: Alcohol; Hypertension; Cardiovascular Disease.

Keywords:

-,

PDF

___

Altun B, Arici M, Nergizoglu G, Derici U, Karatan O, Turgan C, et al. Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens 2005;23:1817-23.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206-52.
Klatsky AL, Friedman GD, Siegelaub AB, Gerard MJ. Alcohol consumption and blood pressure Kaiser-Permanente Multiphasic Health Examination data. N Engl J Med 1977;296:1194-200.
Arkwright PD, Beilin LJ, Rouse I, Armstrong BK, Vandongen R. Effects of alcohol use and other aspects of lifestyle on blood pressure levels and prevalence of hypertension in a working population. Circulation 1982;66:60-6.
Nanchahal K, Ashton WD, Wood DA. Alcohol consumption, metabolic cardiovascular risk factors and hypertension in women. Int J Epidemiol 2000;29:57-64.
Vasdev S, Gill V, Singal PK. Beneficial effect of low ethanol intake on the cardiovascular system: possible biochemical mechanisms. Vasc Health Risk Manag 2006;2:263-76.
Opie LH, Lecour S. The red wine hypothesis: from concepts to protective signalling molecules. Eur Heart J 2007;28:1683-93.
Marques-Vidal P, Arveiler D, Evans A, Amouyel P, Ferrieres J, Ducimetiere P. Different alcohol drinking and blood pressure relationships in France and Northern Ireland: The PRIME Study. Hypertension 2001;38:1361-6.
Carollo C, Presti RL, Caimi G. Wine, diet, and arterial hypertension. Angiology 2007;58:92-6.
Klatsky AL. Alcohol-associated hypertension: when one drinks makes a difference. Hypertension 2004;44:805-6.
Beilin LJ, Puddey IB. Alcohol and hypertension: an update. Hypertension 2006;47:1035-8.
Sesso HD, Cook NR, Buring JE, Manson JE, Gaziano JM. Alcohol consumption and the risk of hypertension in women and men. Hypertension 2008;51:1080-7.
Abdel-Rahman AA, Wooles WR. Ethanol-induced hypertension involves impairment of baroreceptors. Hypertension 1987;10:67-73.
Marmot MG, Elliott P, Shipley MJ, Dyer AR, Ueshima H, Beevers DG, et al. Alcohol and blood pressure: the INTERSALT study. Bmj 1994;308:1263-7.
Kannam JP, Levy D, Larson M, Wilson PW. Short stature and risk for mortality and cardiovascular disease events. The Framingham Heart Study. Circulation 1994;90:2241-7.
Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: The Atherosclerosis Risk in Communities Study. Hypertension 2001;37:1242-50.
Onat A, Hergenç G, Küçükdurmaz Z, Uğur M, Kaya Z, Can G, ve ark. Halkımızda Ilımlı ve Aşırı Alkol Tüketimi: Mortalite ve Kardiyometabolik Risk Üzerine Uzun Vadeli Etkiler. Türk Kardiyol Dern Arş 2009;37:83-90.
Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Res Health 1999;23:40-54.
Beilin LJ, Puddey IB. Alcohol, hypertension and cardiovascular disease--implications for management. Clin Exp Hypertens 1993;15:1157-70.
Clark LT. Role of electrolytes in the etiology of alcohol-induced hypertension. Magnesium 1989;8:124-31.
Husain K, Vazquez-Ortiz M, Lalla J. Down regulation of aortic nitric oxide and antioxidant systems in chronic alcohol-induced hypertension in rats. Hum Exp Toxicol 2007;26:427-34.
Zhang C, Qin YY, Chen Q, Jiang H, Chen XZ, Xu CL, et al. Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies. Int J Cardiol 2014;174:669-77.
Kloner RA, Rezkalla SH. To drink or not to drink? That is the question. Circulation 2007;116:1306-17.