Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union.
Journal: BMC medicine
Volume: 15
Issue: 1
Year of Publication: 2018
Affiliated Institutions:
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
Substance Use, Policy and Practice, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
Primary Care Center La Eria, Oviedo, Spain.
Health and Wellbeing Directorate, Public Health England, London, UK.
CESP, University Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France.
Copentown Healthcare Consultants, Cape Town, South Africa.
Primary Health Center, Raval Nord, Barcelona, Spain.
Sardenya Primary Health Care Center, Biomedical Research Institute Sant Pau, Barcelona, Spain.
General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD), Lisbon, Portugal.
Program on Substance Abuse, Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Barcelona, Spain.
Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, USA.
Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain.
IFT Institut für Therapieforschung, Munich, Germany.
Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia.
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. jakob.manthey@tu-dresden.de.
Division of Noncommunicable Diseases through the Life Course, WHO Regional Office for Europe, Copenhagen, Denmark.
Centrum pre Liecbu Drogovych Zavislosti, Bratislava, Slovakia.
National Observatory on Alcohol, National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy.
Centre for Interdisciplinary Addiction Research, Hamburg University, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany.
Hypertension and Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
Research Institute on Addictions, Federal Medical Research Centre for Psychiatry and Narcology n.a. V. Serbsky, Moscow, Russia.
Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
Drugs Intervention Group, semFYC, Ibiza Primary Health Care Center, Madrid, Spain.
Abstract summary
Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets.A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded.Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries.The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.
Authors & Co-authors:
Rehm Jürgen J
Anderson Peter P
Prieto Jose Angel Arbesu JAA
Armstrong Iain I
Aubin Henri-Jean HJ
Bachmann Michael M
Bastus Nuria Bastida NB
Brotons Carlos C
Burton Robyn R
Cardoso Manuel M
Colom Joan J
Duprez Daniel D
Gmel Gerrit G
Gual Antoni A
Kraus Ludwig L
Kreutz Reinhold R
Liira Helena H
Manthey Jakob J
Møller Lars L
Okruhlica Ľubomír Ľ
Roerecke Michael M
Scafato Emanuele E
Schulte Bernd B
Segura-Garcia Lidia L
Shield Kevin David KD
Sierra Cristina C
Vyshinskiy Konstantin K
Wojnar Marcin M
Zarco José J
Study Outcome
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