Blood pressure and left verticle function in alcoholics

Abstract

Background The aim of the study was to evaluate the effect of acute alcohol withdrawal on blood pressure measured by ABPM as compared with blood pressure after month of abstinence and to evaluate changes in insulin secretion and in left ventricle function.
Methods The following examinations were performed twice by in-clinic patients i.e. between the 2nd and 7th day of alcohol withdrawal and then after month of abstinence: ABPM, laboratory tests, (standard oral glucose tolerance test SOGTT with insulinemia determination), echocardiography (2D, M-mode and PW-Doppler). Statistical analysis was performed using Student t-test, the differences were significant at p<0.05 Patients The study population consisted of 50 normotensives (mean age 36.3+5.4 years) with a history of alcohol abuse for a mean of 12 years. Main outcome We expected influence of drinking cessation on blood pressure lowering and left ventricular function mediated by insulin. Results During acute alcohol restriction significantly higher were: mean systolic blood pressure 121.6+7.7 vs. 115.8+8.7 mmHg, mean diastolic blood pressure 74.5+6.3 vs. 72.0+7.9 mmHg and blood pressure load, the nocturnal fall of diastolic blood pressure was smaller and blood pressure variability was blunted. Acute alcohol withdrawal was also characterised by hyperinsulinemia in SOGTT (measured by ln.sum of secreted insulin) - 8,957mU/l/min vs. 8,558mU/l/min (p<0.001) and hyperdynamic circulation with the CI=3.38+0.86 l/min/m2 at first observation vs. CI=3.09+0.69 I/min/m2 at second (p<0.001). Hyperinsulinemia and CI at first observation were significantly correlated (r=0.39). A positive consequence of one month's abstinence was ari increased E/A ratio - 1,98+0,4 vs 2.08+0,5 (p<0.01).
Conclusions Cessation of drinking decreases blood pressure, improves its circadian profile and improves left ventricular diastolic function. Hyperinsulinemia observed during acute alcohol restriction seems responsible for hyperdynamic circulation.