ALCOHOL
Alcohol consumption has been shown to have a biphasic effect on blood pressure. Small amounts of alcohol appear to lower blood pressure, presumably secondary to a vasodilator effect, but as alcohol consumption increases, blood pressure rises. The dose-response characteristics vary from individual to individual and may be based on factors such as body surface area, gender, and race. The racial differences may be explicable, in part, by virtue of genetic differences ip alcohol metabolism. The mechanism for the alcohol-induced increase in blood pressure appears to be related to activation of, or increased responsiveness to, the sympathetic nervous system. This is manifested by an increase in cardiac output when more than one ounce of alcohol is consumed. Thus, a prudent recommendation to hypertensive subjects is to limit their daily alcohol consumption to no more than 2 oz (60 mL) of 100-proof spirits (or 2.5 oz of 80-proof whiskey), 24 oz (720 mL) of beer or 10 oz (300 mL) of wine. For those hypertensive individuals in whom habitual alcohol consumption exceeds these levels, a reduction in intake may lower blood pressure or make it easier to control.
DIETS
A variety of dietary and lifestyle factors can influence blood pressure, these factors are reviewed. The ideal recommendation for individuals who are hypertensive or are at increased risk for its development are to maintain a body weight as close to ideal as possible; to consume a diet modest in salt content and enriched with fresh fruits, vegetables, and low-fat dairy products, and to consume no more than the recommended optimal amounts of alcohol.
