Alcohol and blood pressure and its interaction with smoking and other behavioural variables: results from the MONICA Augsburg Survey 1984-1985

Abstract
Data from the Augsburg Survey 1984-1985 of the WHO-project Monitoring Trends and Determinants in Cardiovascular Disease (MONICA), a cross-sectional study on a two-stage cluster sample (n = 5312) of the 25-64-year-old population of the Augsburg study area, were analyzed with regard to alcohol consumption and blood pressure. Putative confounders such as age, body mass index, smoking, sporting activity and educational attainment were controlled for by multiple regression analyses. The main effect models showed that men aged 25-64 years consuming greater than or equal to 80 g alcohol per day had, on average, 3-11 mmHg higher systolic blood pressure (SBP) values and 2-6 mmHg higher diastolic blood pressure (DBP) values compared with non-drinkers. Women consuming greater than or equal to 40 g alcohol per day showed consistently higher SBP (2-6 mmHg) and DBP (1-5 mmHg) values compared with non-drinkers. In the group aged 55-64 years, no clear relationship was seen for SBP or DBP in men or women. Multiple regression models, allowing for interactions between alcohol consumption and the four behavioural variables: smoking, sporting activity; coffee consumption; and type A/B behaviour, showed a consistent interaction between alcohol consumption and smoking in men and women. Smoking modified the effect of alcohol on SBP and DBP in men by 2-8 mmHg and in women by 1-14 mmHg. These findings confirm those obtained for women in previous studies in Munich and Lübeck. Interactions between alcohol and sporting activity, coffee consumption and type A/B behaviour are less consistent.