Blood pressure reduction during treatment for alcohol dependence: results from the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study

Aims  Heavy drinking is associated with hypertension. This study evaluated blood pressure changes occurring during treatment for alcohol dependence. Participants  Subjects included 1383 people participating in the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study, a large multi‐center treatment study for alcohol dependence. Measurements  Methods appropriate for repeated‐measures data were used to assess the relationship of percentage of drinking days (PDD) to systolic and diastolic blood pressure over a 16‐week treatment period. Modification of these associations by demographic and other variables was assessed. Findings  Blood pressure reduction was evident only in people who were above the median blood pressure at baseline. In this group, systolic blood pressure decreased by an average of 12 mmHg and diastolic blood pressure decreased by an average of 8 mmHg. Blood pressure reduction occurred during the first month of treatment. This effect was similar regardless of age, sex, body mass index, reported history of hypertension and use of anti‐hypertensive medications. An observed association between blood pressure and PDD in Caucasians was not evident in African Americans due largely to their lower pre‐treatment blood pressure. Conclusions  Reduction in alcohol consumption has a potent anti‐hypertensive effect in alcoholics with higher blood pressure. For hypertensive, alcohol‐dependent people, treatment for alcoholism should be considered a major component of anti‐hypertensive therapy.