Alcohol consumption in stage 1 hypertensive subjects increases the risk of developing prediabetes

Abstract

Purpose: The association of alcohol use with risk of prediabetes is controversial. We did a prospective study to investigate whether alcohol consumption was an independent predictor of risk of prediabetes in the early stage of hypertension. Methods: The study was conducted in a cohort of 1177 stage 1 hypertensive subjects from the HARVEST. Data were adjusted for age, gender, body mass index, physical activity habits, duration of hypertension, and cigarette smoking. Participants were divided into four groups: 1) nondrinkers, 2) mild drinkers (< 50 g/day), 3) moderate drinkers (50-100 g/day), and 4) heavy drinkers (> 100 g/day). Mean follow-up duration was 6.5 years. Results: Participants with alcohol consumption ≥50 g/day had higher serum glucose (p=0.02) and total cholesterol (p=0.03) concentrations. Heavy alcohol drinkers had an increased risk of sustained hypertension compared to nondrinkers (hazard ratio, 95% CI: 3.1, 1.4-7.2). At follow-up end, 282 subjects met the criteria for prediabetes (serum glucose between 100 and 125 mg/dL). In a multivariable Cox regression model using prediabetes as the outcome variable, alcohol use was significantly associated with prediabetes (p<0.006). However, the risk of prediabetes was not increased among the mild alcohol users (p=0.42), whereas it was increased among the moderate users (hazard ratio, 95% CI: 1.6, 1.1-2.5) and the heavy users (4.2, 1.5-11.9). The association between alcohol consumption and risk of prediabetes remained unchanged when change of body weight during follow-up was included in the Cox model (p=0.006) and was slightly attenuated when baseline systolic and diastolic blood pressures were incorporated (p=0.01). When baseline serum glucose, cholesterol and triglycerides were included in the model, moderate alcohol drinking was no longer associated with outcome (p=0.38) but the risk of prediabetes remained elevated in the heavy alcohol drinkers (hazard ratio, 95% CI: 6.4, 1.9-21.1). Conclusion: Moderate and heavy alcohol drinking (≥ 50 g/die) is associated with a poorer metabolic profile and an increased risk of developing prediabetes.