Smoking, excessive alcohol consumption and lack of exercise are the three major bad lifestyles that seriously damage human health. Long-term excessive alcohol consumption not only damages the liver, heart and nervous system, but may also be associated with chronic diseases such as hypertension and diabetes. As the Chinese New Year is approaching, we will discuss with you the knowledge of “hypertension and diabetes” and how chronic disease patients can enjoy themselves and harm their health at the same time.
The effect of moderate alcohol consumption on blood pressure is uncertain
Epidemiological studies and observational studies in Europe and the United States suggest that there may be a J-shaped relationship between alcohol intake and cardiovascular disease risk, and that moderate alcohol consumption has some cardiovascular protective benefits. The cardiovascular protective benefits of moderate alcohol consumption have been attributed to a variety of mechanisms, including increased plasma HDL cholesterol levels, improved glucose metabolism and insulin sensitivity leading to reduced risk of diabetes, and improved endothelial function. However, these claims have not been validated by prospective randomized studies.
The relationship between alcohol consumption and blood pressure is difficult to assess because the development of hypertension is associated with multiple factors and various factors interact with each other, and the role of a single factor is not easily determined.
The results of our Kailuan study with a 4-year follow-up suggest that chronic alcohol consumption is an independent risk factor for hypertension and that even small amounts of alcohol consumption can increase the risk of hypertension. Currently, most experts focus on the relationship between excessive alcohol consumption and hypertension.
The relationship between excessive alcohol consumption and hypertension
Excessive alcohol consumption contributes to increased all-cause mortality, is more harmful to young people, and is an independent risk factor for hypertension. For example, the International Multicenter Study surveyed 9,681 young and middle-aged individuals aged 20-59 years in 48 centers worldwide and found that compared to non-drinkers, the average blood pressure was 2.7/1.6mmHg higher in men who drank 300-499ml per week, 4.6/3.0mmHg higher in men who drank 500ml per week, and 3.9/3.0mmHg higher in women who drank 300ml per week. The increase was 3.9/3.1mmHg for women who drank 300ml per week.
A study in China showed that excessive drinkers (30 standard drinks per week) developed simple systolic hypertension compared to non-drinkers. Compared to Western countries, East Asian populations such as China are more sensitive to alcohol, and lower alcohol consumption may significantly raise blood pressure.
Prevention and treatment of alcohol-induced hypertension
The proportion of alcohol-induced hypertension in the population with essential hypertension varies from 5% to 30% in the literature. Excessive alcohol consumption contributes to the development of hypertension in a significantly larger number of patients. An effective way to prevent alcohol-induced hypertension is to drink less alcohol or no alcohol at all.
Studies have shown that excessive drinkers, whether with normal or increased blood pressure, have some reduction in systolic and diastolic blood pressure levels after reducing the amount of alcohol consumed or abstaining from alcohol. The treatment of alcohol-induced hypertension is similar to the treatment of primary hypertension, with the difference that reducing the amount of alcohol consumed or abstaining from alcohol can lower blood pressure, especially systolic blood pressure, and those who drink severely in excess should gradually reduce the amount of alcohol consumed over a period of 1 to 2 weeks. Another non-pharmacological approach to the prevention and treatment of alcohol-induced hypertension is exercise. In a rat model, exercise increased nitric oxide production, upregulated the antioxidant stress capacity of the cardiovascular system, and reduced alcohol-induced hypertension by inducing nitric oxide synthase production.
The optimal drug regimen for the treatment of alcohol-induced hypertension is unclear, and some experts suggest that angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists are preferred for the possible pathogenesis. Animal studies have shown that RAAS activation and abnormal left ventricular systolic function persist after alcohol feeding in experimental dogs, and irbesartan improves all indicators of left ventricular function. In response to the pathogenesis, calcium antagonists may also be the preferred agents for the treatment of alcohol-induced hypertension.
Effects of alcohol consumption on diabetes
First, if diabetic patients drink large amounts of alcohol, especially on an empty stomach, ethanol rapidly enters the liver, inhibiting the breakdown and allogenesis of hepatic glycogen, leading to the development of hypoglycemia. Secondly, ethanol will increase the blood flow to insulin-secreting pancreatic islet cells, thus causing a significant increase in insulin secretion, resulting in hypoglycemia after drinking. Glucose is the main source of energy for brain tissue, but the amount of sugar stored in brain cells is limited and can only sustain brain cell activity for a few minutes, so once hypoglycemia occurs, there can be brain dysfunction, leading to coma.
If treated in time, most patients can recover quickly without permanent sequelae, but if the hypoglycemic coma lasts for more than 6 hours, the degeneration of brain cells will be irreversible, and patients will suffer from brain edema and central nervous damage due to prolonged hypoglycemia, leaving different degrees of neurological impairment and even death.
Other hazards
Alcohol may mask the symptoms of hypoglycemia; increase blood pressure and blood lipids, resulting in a sudden increase in the incidence of cardiovascular risk; excessive alcohol may aggravate the symptoms of diabetic neuropathy; the existing hypogonadism of long-term drinkers may be aggravated; reduce one’s judgment, and the patient may forget to take insulin injections or eat.
For alcoholics, the alcohol and other ingredients in “wine” contain high energy, and because of the excitement of alcohol, the drinker’s self-control decreases, and the amount of food cannot be controlled, making the blood sugar rise and the condition worsen, which can cause diabetic ketoacidosis in serious cases and endanger life. The high calorie content of alcohol causes alcohol to become the primary source of calories for alcoholics, with little intake of other foods, resulting in a lack of nutrients such as protein, fat, carbohydrates, minerals and vitamins.
Precautions for drinking alcohol in diabetics
Blood sugar must be well controlled, below 7.8mmol/L; non-obese; no significant chronic diseases other than diabetes; no complications of diabetes and normal liver function; and not taking oral hypoglycemic drugs or insulin injections.
Control the total amount of alcohol consumed
The total amount of alcohol consumed at a meal should be within 15g, and relaxed to 20g for those who have alcohol. 15-20g of alcohol is roughly equivalent to 60-80ml of 30-degree white wine, 120-150ml of wine, 300-400ml of beer and 70ml of whiskey, which is the maximum allowable amount, and should be reduced by half when drinking, and the drinking speed should be slowed down.
Never drink alcohol on an empty stomach
Before attending a banquet, you should eat carbohydrate-rich food first, and pay attention to drinking alcohol while eating during the banquet.