Clinical characteristics of patients with alcohol dependence comorbid with hypertension among regular drinkers: An internet-based, cross-sectional study in Japan.

ABSTRACT

While evidence suggests a strong association between alcohol and hypertension, little is known about the profile of patients with alcohol dependence comorbid with hypertension. This study aimed to clarify the clinical characteristics and health problems of this population through a web-based questionnaire survey using a research company's panel of adults in Japan. Of 20 000 regular drinkers, 176 on treatment for hypertension and with alcohol dependence (confirmed and/or an Alcohol Use Disorders Identification Test score ≥15 points) were included. Participants were asked about their health-related quality of life, work productivity, blood pressure (BP) control, receipt of brief interventions, and awareness of their alcohol dependence. Results were compared between the BP-controlled and BP-uncontrolled groups. The mean EQ-5D utility score was 0.838 in the entire population, and 0.786 vs. 0.892 in the groups (p < 0.0001). When 133 'employed' participants were compared, productivity loss was more apparent in the BP-uncontrolled group (presenteeism, 27.3% vs. 6.1%, p < 0.0001; absenteeism, 10.7% vs. 1.0%, p = 0.0003). The rate of dissatisfaction with BP control was 55.1% in the entire population (most [76.3%] of those dissatisfied considered alcohol a cause of inadequate BP control), ~78% in the uncontrolled group, and ~34% in the controlled group. Of those previously advised to reduce drinking or abstain from alcohol (60.2% of all participants), 63% (BP-uncontrolled group) and 55% (BP-controlled group) decreased their drinking. Though more than twice as many participants thought themselves to be alcohol-dependent in the BP-uncontrolled group than in the controlled group (41% vs. 15%), most (59% vs. 85%) showed no self-awareness of alcohol dependence. Patients with alcohol dependence comorbid with hypertension had impaired health status and reduced work productivity. They thought alcohol was the most common cause of inadequate BP control. Treatment beyond brief interventions is needed to enhance their awareness of alcohol dependence and their motivation to reduce drinking.