Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men

A large new Japanese study suggests that middle-aged men who drink heavily could see their blood pressure rise, regardless of whether their levels of "good" cholesterol also go up.

Study author Ichiro Wakabayashi also found that the older men who participated - all in their 50s - were more susceptible to the blood pressure-boosting effects of heavy drinking than younger men.

While there are signs that drinking can be good for the heart and boost good cholesterol levels, “this emphasizes that alcohol is not for everyone,” said Kenneth Mukamal, M.D., an assistant professor of medicine at Harvard Medical School who is familiar with the study findings.

“This really fits well with the observation that the risk of stroke - which is more sensitive to blood pressure than heart attack - is not really substantially lower in moderate drinkers,” Mukamal said. According to him, an increase in blood pressure might eliminate any benefit from higher levels of good cholesterol.

Wakabayashi, of the Hyogo College of Medicine in Japan, launched the study to explore whether high-density lipoprotein (HDL) cholesterol - which is thought to protect the heart from disease - might play a role in how drinking affects blood pressure in men.

He looked at two groups of male workers, one 20 to 29 years old and the other 50 to 59 - in all, 21,301 subjects. All had periodic health examinations.

Young drinkers with low HDL cholesterol levels were no more likely to have high blood pressure than were nondrinkers with similar cholesterol levels.

However, young men who drank heavily and had higher levels of HDL were more likely than nondrinkers were to have high blood pressure, suggesting that the “good” cholesterol did not stop the bad effects of drinking.

When looking at men of all ages, those with the lowest level of good cholesterol had the highest blood pressure in all three groups: nondrinkers, moderate drinkers and heavy drinkers. However, high levels of good cholesterol HDL did not do as much for the heavy drinkers.

Among older men, blood pressure was “significantly higher” in both light and heavy drinkers, regardless of their HDL cholesterol levels, according to the study. Author Wakabayashi was not available for comment.

The findings appear in the September issue of the journal Alcoholism: Clinical and Experimental Research .

So should men of a certain age stop drinking? It all depends on how much they are imbibing, said Arthur Klatsky, M.D., senior consultant in cardiology at the Kaiser Permanente Medical Center in Oakland, Calif.

In middle-aged and older people who have reached the ages when heart attacks are more common, “light to moderate drinking appears to reduce that risk,” said Klatsky, who studies alcohol use and is familiar with the study findings.

On the other hand, Klatsky said, “people who drink a lot of alcohol ought to drink less or quit. This study doesn't affect that message one way or another.”

Alcoholism: Clinical and Experimental Research : Contact Mary Newcomb at (317) 375-0819 or [email protected] or visit http://www.alcoholism-cer.com

Wakabayashi I. Blood HDL cholesterol levels influence association of alcohol intake with blood pressure in young men but not in middle-aged men. Alcoholism: Clinical and Experimental Research 31(9), 2007.