EFFECTS OF ALCOHOL AND CALORIC RESTRICTIONS ON BLOOD-PRESSURE AND SERUM-LIPIDS IN OVERWEIGHT MEN

We have examined the independent and combined effects on blood pressure and blood lipids of alcohol restriction and weight loss in overweight male drinkers with a view to assessing overall effects on cardiovascular risk of two widely promoted nonpharmacological approaches for hypertension. Eighty-six men with a mean age of 44.3 years, a mean regular alcohol intake of 440 ml/wk (five or six standard drinks per day), a mean blood pressure of 137.4 mm Hg systolic and 84.8 mm Hg diastolic, and a mean body mass of 92.5 kg entered a controlled two-way factorial study. The subjects were randomly assigned to four groups for an 18-week intervention in which members of two groups drank only low-alcohol beer, thereby reducing their alcohol intake by 374 ml/wk, while those of the other two groups continued their normal alcohol intake. Within the low and normal alcohol intake groups subjects either continued their usual diet or reduced their caloric intake by 4,200-6,300 kJ/day (1,000-1,500 kcal/day) (with protein, fat, and carbohydrate provided as 15%,30%, and 55% of total calories, respectively). Calorie reduction and alcohol restriction caused weight losses of 7.5 (p<0.001) and 2.1 (p<0.01) kg, respectively. Calorie reduction and alcohol restriction were associated with decreases in systolic blood pressure of 5.4 (p<0.001) and 4.8 (p<0.01) mm Hg, respectively, and in diastolic blood pressure of 4.2 (p<0.001) and 3.3 (p<0.01) mm Hg, respectively. The combined measures had additive effects on blood pressure reduction, giving decreases of 10.2 mm Hg systolic and 7.5 mm Hg diastolic supine and 14.3 mm Hg systolic and 7.5 mm Hg diastolic standing. With alcohol restriction, total cholesterol concentration fell 0.49 mmol/l (p<0.05), the triglyceride level fell 0.63 mmol/l (p<0.01), and the high density lipoprotein (HDL)-cholesterol concentration fell 0.15 mmol/l (p<0.001). With caloric reduction alone, total cholesterol concentration fell 0.40 mmol/l (p=0.07) and the triglyceride level fell 0.81 mmol/l (p<0.001), but the HDL-cholesterol concentration rose 0.11 mmol/l (p<0.05). The combined measures prevented a potentially adverse alcohol-related decrease in the HDL-cholesterol level and had additive effects in reducing total cholesterol and triglyceride concentrations. We conclude that the combination of reduced alcohol consumption and weight loss from calorie restriction leads to substantial and sustained reductions in blood pressure and to improved blood lipid profiles. These combined strategies offer a valuable approach to modification of cardiovascular risk in overweight male drinkers.