This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (30)  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in this journal  Topic Collections  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

William C. Cushman, MD; Jeffrey A. Cutler, MD; Eleanor Hanna, PhD; Stephen F. Bingham, PhD; Dean Follmann, PhD; Thomas Harford, PhD; Patricia Dubbert, PhD; P. Scott Allender, MD; Mary Dufour, MD; Joseph F. Collins, ScD; Sandra M. Walsh, MA; Gail F. Kirk, MS; Matthew Burg, PhD; James V. Felicetta, MD; Bruce P. Hamilton, MD; Lois Anne Katz, MD; H. Mitchell Perry, Jr, MD; Mark L. Willenbring, MD; Raj Lakshman, PhD; Robert J. Hamburger, MD; for the PATHS Group

Arch Intern Med. 1998;158:1197-1207.

Objectives  To determine whether blood pressure is reduced for at least 6 months with an intervention to lower alcohol intake in moderate to heavy drinkers with above optimal to slightly elevated diastolic blood pressure, and whether reduction of alcohol intake can be maintained for 2 years.

Design  A randomized controlled trial.

Methods  Six hundred forty-one outpatient veterans with an average intake of 3 or more alcoholic drinks per day in the 6 months before entry into the study and with diastolic blood pressure 80 to 99 mm Hg were randomly assigned to a cognitive-behavioral alcohol reduction intervention program or a control observation group for 15 to 24 months. The goal of the intervention was the lower of 2 or fewer drinks daily or a 50% reduction in intake. A subgroup with hypertension was defined as having a diastolic blood pressure of 90 to 99 mm Hg, or 80 to 99 mm Hg if recently taking medication for hypertension.

Results  Reduction in average weekly self-reported alcohol intake was significantly greater (P<.001) at every assessment from 3 to 24 months in the intervention group vs the control group: levels declined from 432 g/wk at baseline by 202 g/wk in the intervention group and from 445 g/wk by 78 g/wk in the control group in the first 6 months, with similar reductions after 24 months. The intervention group had a 1.2/0.7–mm Hg greater reduction in blood pressure than the control group (for each, P=.17 and P=.18) for the 6-month primary end point; for the hypertensive stratum the difference was 0.9/0.7 mm Hg (for each, P=.58 and P=.44).

Conclusions  The 1.3 drinks per day average difference between changes in self-reported alcohol intake observed in this trial produced only small nonsignificant effects on blood pressure. The results from the Prevention and Treatment of Hypertension Study (PATHS) do not provide strong support for reducing alcohol consumption in nondependent moderate drinkers as a sole method for the prevention or treatment of hypertension.

From the Veterans Affairs Medical Center, Memphis, Tenn (Dr Cushman and Ms Walsh); National Heart, Lung, and Blood Institute, Bethesda, Md (Drs Cutler, Follmann, and Allender); National Institute on Alcohol Abuse and Alcoholism, Rockville, Md (Drs Hanna, Harford, and Dufour); Perry Point Veterans Affairs Cooperative Studies Program Coordinating Center, Perry Point, Md (Drs Bingham and Collins and Ms Kirk); Veterans Affairs Medical Center, Jackson, Miss (Dr Dubbert); Veterans Affairs Medical Center, West Haven, Conn (Dr Burg); Veterans Affairs Medical Center, Phoenix, Ariz (Dr Felicetta); Veterans Affairs Medical Center, Baltimore, Md (Dr Hamilton); Veterans Affairs Medical Center, New York, NY (Dr Katz); Veterans Affairs Medical Center, St Louis, Mo (Dr Perry); Veterans Affairs Medical Center, Minneapolis, Minn (Dr Willenbring); Central Lipids Laboratory, Veterans Affairs Medical Center, Washington, DC (Dr Lakshman); and Central Renal Laboratory, Veterans Affairs Medical Center, Boston, Mass (Dr Hamburger).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Failure of Alcohol Reduction to Lower Blood Pressure in the PATHS Trial
Christopher J. Bulpitt, Martin J. Shipley, William C. Cushman, and Eleanor Hanna
Arch Intern Med. 1999;159(2):195-196.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

To Drink or Not to Drink? That Is the Question
Kloner and Rezkalla
Circulation 2007;116:1306-1317.
ABSTRACT | FULL TEXT  

Alcohol Consumption and Risk for Coronary Heart Disease among Men with Hypertension
Beulens et al.
ANN INTERN MED 2007;146:10-19.
ABSTRACT | FULL TEXT  

Randomized Controlled Trial on Lifestyle Modification in Hypertensive Patients
Cakir and Pinar
West J Nurs Res 2006;28:190-209.
ABSTRACT  

Alcohol and the Cardiovascular System: Research Challenges and Opportunities
Lucas et al.
J Am Coll Cardiol 2005;45:1916-1924.
ABSTRACT | FULL TEXT  

Management of Prehypertension
Svetkey
Hypertension 2005;45:1056-1061.
FULL TEXT  

Effects of Alcohol Reduction on Blood Pressure: A Meta-Analysis of Randomized Controlled Trials
Xin et al.
Hypertension 2001;38:1112-1117.
ABSTRACT | FULL TEXT  

AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
J. Nutr. 2001;131:132-146.
FULL TEXT  

AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
Stroke 2000;31:2751-2766.
FULL TEXT  

AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
Circulation 2000;102:2284-2299.
FULL TEXT  

Failure of Alcohol Reduction to Lower Blood Pressure in the PATHS Trial
Bulpitt et al.
Arch Intern Med 1999;159:195-196.
FULL TEXT