Alcohol drinking patterns and blood pressure.

BACKGROUND: Although blood pressure tends to increase with average alcohol consumption, little is known about the effects of drinking patterns on blood pressure. Therefore, the effects of average drinks per day and drinking pattern (defined as the independent and interactive effects of quantity and frequency) on blood pressure were compared. METHODS: Data were obtained from a random sample survey of 1,635 household residents in Erie County, New York. Alcohol-blood pressure relationships were examined using multiple regression analyses that controlled for the potentially confounding influence of 13 additional risk factors for elevated blood pressure. RESULTS: Consistent with prior research, a positive relationship was found between average drinks per day and diastolic and systolic blood pressure. Analyses examining the effect of drinking pattern indicated that drinking frequency had a positive effect on both diastolic and systolic blood pressure, whereas drinking quantity did not affect either. Furthermore, there was little evidence that the frequency-by-quantity interaction affected blood pressure. CONCLUSIONS: Low average alcohol intake and low blood pressure were associated with infrequent drinking, rather than with frequent drinking of small amounts of alcohol. Results suggest that the standard practice of averaging alcohol consumption may obscure important effects of drinking frequency on health.     

Women''s drinking and drinking problems: patterns from a 1981 national survey

A 1981 national survey of women's drinking interviewed 917 women in the general population, stratified on the basis of screening interviews to include 500 moderate-to-heavy drinkers. The survey found no evidence of any major recent increase in women's drinking, and no evidence of unusually heavy drinking among working wives. Adverse drinking consequences and episodes of extreme drinking were most common among women aged 21-34; women who were unmarried, divorced or separated, or cohabiting; and women with frequent drinkers as spouses or companions. Alcohol-related behavior problems and symptoms of alcohol dependence were closely related to levels of alcohol consumption. Among women averaging one ounce or more of ethanol per day, 45 per cent had driven while intoxicated in the past year, and 36 per cent reported memory lapses while drinking. Women at this consumption level were also more likely to report experiences with depression (61 per cent). Women with extremely high consumption levels were more likely to have histories of obstetrical and gynecological problems. Some women with alcohol-related problems reported periods of temporary abstention, a pattern not studied heretofore.     

Alcohol consumption, drinking pattern and blood pressure: analysis of data from the Italian National Research Council Study

The present analyses addressed the relationship between alcohol consumption, drinking patterns and hypertension in 6699 Italian men and women participating in a national project on arteriosclerosis risk factors. The results of the analyses are consistent with an association between heavy alcohol consumption and systolic blood pressure in both males and females. Higher diastolic blood pressure was associated with heavy alcohol consumption in men but not in women. Drinkers of wine both with and without meals have a higher prevalence of hypertension than abstainers in both sexes. We conclude that heavy alcohol consumption is associated with higher blood pressure values, and that the pattern of drinking could be an important determinant in the association between alcohol and hypertension.     

A longitudinal study of blood pressure in a national survey of children.

Blood pressure changes over a three- to four-year period were studies in a cohort of 2,168 children examined during the US Heath Examination Survey. The sample used is a representative subset of a national probability sample. Significant positive correlations between initial and follow-up blood pressures were observed. In addition, relatively obese children tended to demonstrate higher blood pressures within age-race-sex specific subgroups.     

Public attitudes about underage drinking policies: results from a national survey

We conducted a national telephone survey of 900 adults in the United States to examine the attitudes of the adult public regarding underage drinking and a series of alcohol control policies aimed at reducing it. Three versions of the survey instrument were administered, each to one-third of the sample, with the versions varying in the stipulations of the policy options. Results showed high levels of public support for most of the alcohol control policies, with relatively lower support for those that would result in restrictions on adults' access to alcohol. Respondents' support of the policy options was significantly related to their sociodemographic and attitudinal characteristics, such as sex, age, drinking frequency, and level of concern about underage drinking. The findings provide important guidelines to policymakers interested in garnering support for policies aimed at curtailing underage drinking.     

Alcohol consumption and blood pressure: analysis of data from the Canada Health Survey

Recent epidemiologic studies report a significant association between alcohol consumption and elevations in both systolic (SBP) and diastolic (DBP) blood pressures. To test this hypothesis, we conducted a multivariate analysis of physical examination and other data on 721 men and 697 women aged 20 or more collected during the Canada Health Survey in 1978-1979. SBP and DBP were considered as separate dependent variables in multiple regression models with the following independent variables: age, alcohol consumption (measured as a 7-day recall history and as an average frequency of consumption), serum cholesterol, plasma glucose, physical activity, Quetelet index, parental history of hypertension, cigarette consumption, income, education, and exogenous hormonal use in women. In both weighted and unweighted multiple regression analyses, we could not demonstrate for either sex, a significant association between alcohol consumption (as recorded and following quadratic and logarithmic transformations) and either SBP or DBP. For both sexes, only age and Quetelet index were highly significantly (P less than 0.0001) and consistently associated with both SBP and DBP. No other independent variables were consistently associated, for either sex, with SBP and DBP. Further, the dose-response patterns noted by other investigators suggesting either a positive and linear relationship or a curvilinear relationship were not found in either our univariate or multivariate analyses. Rather, the alcohol-blood pressure curves showed no consistent patterns of any kind in either sex. These findings do not support recent claims that alcohol consumption is a determinant of elevations in either SBP or DBP.     

Relinquishment of premarital births: evidence from national survey data.

According to 1982 and 1988 NSFG data, unmarried white women are far less likely than they were in the early 1970s to place their children for adoption. The levels of relinquishment among black women have remained low throughout this period, and relinquishment among Hispanic women may be virtually nonexistent. Multivariate analysis of the determinants of relinquishment among unmarried non-Hispanic white women suggests that having a well-educated mother, being in school at the time of conception, having no labor force experience, and being older are positively associated with placing a child for adoption. Sons were found to be less likely to be relinquished than daughters.     

Alcohol consumption and heavy drinking: a survey in three Italian villages

Aims: We investigated drinking habits, and heavy and problemdrinking prevalence in a sample of individuals attending theconsulting rooms of local General Practitioners in three Italianvillages. Methods: The samples were selected to be representativeof the entire population of the three villages. Informationon alcohol-drinking patterns was collected using a questionnairethat included a masked form of the CAGE rating scale. Accordingto the frequency of alcohol intake, subjects were grouped inthree categories: abstainers, occasional drinkers, and dailydrinkers. In agreement with WHO guidelines, 40 g/day for malesand 20 g/day for females were taken as cut-off for ‘heavydrinking’ and consumptions of >80 g/day for males and40 g/day for females were used to define ‘problem drinking’.Results: A total of 2972 individuals were included in the survey(19% of the population). Of these, 44% were abstinent, 20% occasionaldrinkers, and 36% daily drinkers. Daily drinking was found tobe more common in males than in females but heavy drinking wassignificantly higher in females compared with males (P 0.0001).The problem drinkers were 12% of the entire population and theCAGE-positive subjects (2 positive answers) were 3.5%. Conclusions:Our data indicate that alcohol drinking is widely diffused inthe three communities. A large layer of the population drinksabove the WHO-established cut-off. The incidence of heavy andproblem drinking seems to have significant gender and regionaldifferences that are important to consider when planning effectiveprevention programmes.     

Changes in body mass index and its relationships to other cardiovascular risk factors among Japanese population: results from the 1980 and 1990 national cardiovascular surveys in Japan.

Few studies have attempted to investigate the changes in body mass index (BMI) and its relationship to other cardiovascular factors in Asian populations, including Japanese. Data from two national cross-sectional surveys on circulatory disorders in 1980 and 1990 in Japan were used in this study. The sample consisted of 10,556 participants in the 1980 survey and 8,385 in the 1990 survey, aged > or = 30 years. The results show that after adjusting for age, smoking, alcohol consumption (ALC) and daily life physical activity (PA), mean BMI increased 0.49 kg/m2 (95% confidence interval: 0.34-0.65) in men aged 30-59 and 0.61 kg/m2 (0.37-0.86) in those aged > or = 60 from 1980 to 1990. In women, however, mean BMI decreased 0.24 kg/m2 (-0.39 0.09) in those aged 30-59 and increased 0.38 kg/m2 (0.12-0.64) in those aged > or = 60. BMI was significantly associated with hypertension, diabetes and hypercholesterolaemia. In both genders, cu-smokers had lower mean BMI than never smokers, while among the cu-smokers, mean BMI was positively associated with the number of cigarettes smoked per day. In men, BMI was positively associated with ALC and negatively associated with PA, while in women, BMI was negatively associated with ALC and positively associated with PA. The results suggest that BMI has significantly increased in men and in elderly women. BMI, even in the Japanese population who are characterized by relative low BMI, is significantly associated with several cardiovascular risk factors.     

Alcohol and other drug specialist treatment services and their managers: findings from a national survey

OBJECTIVE: To examine the characteristics of alcohol and other drug (AOD) specialist treatment agencies, their workforce and workforce development issues. METHODS: A national survey of AOD specialist treatment agency managers was conducted using the Clients of Treatment Service Agencies (COTSA) database as the sampling framework. Agency managers across Australia were surveyed by phone or electronically between April and October 2002. Qualitative and quantitative data were collected. Two hundred and thirty-four managers participated, representing 318 agencies, and a response rate of 65%. More than 50% of managers from each State and Territory participated in the study. RESULTS: The study found a high prevalence of alcohol-related problems. Managers estimated 45% of clients nominated alcohol as their primary problematic drug and that 53% of poly-drug clients identified alcohol-related problems. Managers reported increasingly complex client needs such as co-occurring substance and mental health issues. A harm minimisation treatment approach was supported by more than three-quarters of AOD agencies. The majority of the AOD workforce were trained professionals and consisted of nurses (26%), general AOD workers (19%) and psychologists (9%). Approximately half the sample had been in their current managerial role for less than five years. Key workforce development issues identified were education and training, funding, and staff recruitment and retention. CONCLUSION: More information is required on the key characteristics of the AOD workforce and their workforce development needs. Such information can contribute to policies and strategies that develop the capacity of the AOD sector to manage and treat the increasingly complex needs of clients.     

Alcohol and other drug specialist treatment services and their managers: findings from a national survey

Objective : To examine the characteristics of alcohol and other drug (AOD) specialist treatment agencies, their workforce and workforce development issues.
Methods : A national survey of AOD specialist treatment agency managers was conducted using the Clients of Treatment Service Agencies (COTSA) database as the sampling framework. Agency managers across Australia were surveyed by phone or electronically between April and October 2002. Qualitative and quantitative data were collected. Two hundred and thirty-four managers participated, representing 318 agencies, and a response rate of 65%. More than 50% of managers from each State and Territory participated in the study.
Results : The study found a high prevalence of alcohol-related problems. Managers estimated 45% of clients nominated alcohol as their primary problematic drug and that 53% of poly-drug clients identified alcohol-related problems. Managers reported increasingly complex client needs such as co-occurring substance and mental health issues. A harm minimisation treatment approach was supported by more than three-quarters of AOD agencies. The majority of the AOD workforce were trained professionals and consisted of nurses (26%), general AOD workers (19%) and psychologists (9%). Approximately half the sample had been in their current managerial role for less than five years. Key workforce development issues identified were education and training, funding, and staff recruitment and retention.
Conclusion : More information is required on the key characteristics of the AOD workforce and their workforce development needs. Such information can contribute to policies and strategies that develop the capacity of the AOD sector to manage and treat the increasingly complex needs of clients.     

Condom use and HIV risk behaviors among U.S. adults: data from a national survey

CONTEXT: How much condom use among U.S. adults varies by type of partner or by risk behavior is unclear. Knowledge of such differentials would aid in evaluating the progress being made toward goals for levels of condom use as part of the Healthy People 2000 initiative. METHODS: Data were analyzed from the 1996 National Household Survey of Drug Abuse, an annual household-based probability sample of the noninstitutionalized population aged 12 and older that measures the use of illicit drugs, alcohol and tobacco. The personal behaviors module included 25 questions covering sexual activity in the past year, frequency of condom use in the past year, circumstances of the last sexual encounter and HIV testing. RESULTS: Sixty-two percent of adults reported using a condom at last intercourse outside of an ongoing relationship, while only 19% reported using condoms when the most recent intercourse occurred within a steady relationship. Within ongoing relationships, condom use was highest among respondents who were younger, black, of lower income and from large metropolitan areas. Forty percent of unmarried adults used a condom at last sex, compared with the health objective of 50% for the year 2000. Forty percent of injecting drug users used condoms at last intercourse, compared with the 60% condom use objective for high-risk individuals. Significantly, persons at increased risk for HIV because of their sexual behavior or drug use were not more likely to use condoms than were persons not at increased risk; only 22% used condoms during last intercourse within an ongoing relationship. CONCLUSIONS: Substantial progress has been made toward national goals for increasing condom use. The rates of condom use by individuals at high risk of HIV need to be increased, however, particularly condom use with a steady partner.     

Heterosexual behaviour and HIV risk in New Zealand: data from a national survey

Abstract: The pattern of any future major heterosexual epidemic of acquired immunodeficiency syndrome (AIDS) will depend partly on sexual behaviour and condom use among heterosexuals. This survey was designed to provide information on patterns of sexual behaviour in New Zealand. A national sample aged 18 to 54 was selected using a random method and telephone interviews were administered to 2361 people, using a questionnaire based on the protocol developed by the Global Program on AIDS of the World Health Organization. The reported mean lifetime number of partners increased with age up to 25 to 29 years for women and 30 to 34 years for men, and declined at older ages. Fifteen or more lifetime partners were reported by 17 per cent of men and 4 per cent of women. Multiple partnerships in the previous 12 months were commonest in those aged 20 to 24. In this age group, 32 per cent of men and 20 per cent of women reported two or more partners. Recent condom use for contraception was reported by 23 per cent of men and 19 per cent of women. Use was highest amongst those aged 18 to 24, and decreased sharply with age. The true proportion of the population with many sexual partners may be higher than reported. These data will be useful in modelling approaches to estimate the likelihood of future heterosexual spread of AIDS. The data on lifetime numbers of partners suggest that sexual decisions depend not just on age and sex but also on the era, and thus on changing social values about sexual behaviour.     

Reversal pattern of health inequality: New evidence from a large-scale national survey in Japan

Despite extensive evidence for a positive association between socio-economic status (SES) and health, some studies have shown that this well-established pattern of health inequality is reversed in Japan due to individuals of high SES working in stressful workplace environments. High-SES workers in Japan generally belong to a lifetime employment system (LES) in large companies. Thus, in this study, individuals who had been working for a single company for several decades at the time of a 2005 survey (LES workers) were compared with other workers by logistic regression and ordinary least squares regression. These analyses showed that LES workers had 36% more household savings. However, despite their relatively high income, the LES workers were more likely to develop diabetes (odds ratio 1.134: 95% CI 1.022–1.259) and hyperlipidemia (odds ratio 1.184: 95% CI 1.079–1.300). Among women, LES workers were at higher risk of developing cancer (odds ratio 1.570: 95% CI 1.174–2.098). In addition, these effects were consistently found in subsequent surveys between 2006 and 2015, suggesting that the LES had long-term adverse effects on health. These results taken together show that career trajectory is an important determinant of health inequality in the elderly population.     

Young people and drinking: results of an English national survey

An account is presented of a survey of self-reported drinking habits and beliefs about alcohol amongst a national sample of teenagers in England. Fieldwork was conducted during 1988 and 1989 and involved 27 systematically selected state secondary (high) schools. Respondents were virtually all aged 14-16. The majority of teenagers reported drinking only moderate amounts of alcohol. Even so, a third of the males and nearly a fifth of the females reported having at some time consumed the equivalent of five and a half pints of beer on a single occasion. Factual knowledge about alcohol was not high and more than half of the study group supported a reduction in the legal minimum age at which alcohol may be purchased in licensed premises.     

Knowledge of and attitudes toward the pill: results of a national survey in Japan.

CONTEXT: After decades of debate, the oral contraceptive pill was legalized in Japan in June 1999. Because the pill had been unavailable up until then, little is known about the public's knowledge about, attitudes toward and intentions to use the pill. METHODS: In a nationwide probability sample, 630 women and men were interviewed in their homes in March 1999. Respondents were asked a range of questions to gauge their knowledge about and attitudes toward the pill. RESULTS: Most respondents (79%) could identify both the name and purpose of the birth control pill. Roughly the same proportion of respondents held an overall positive impression (44%) as held a negative impression (42%) of the pill, and 14% were undecided about the method. The pill's high level of effectiveness in pregnancy prevention was the most common reason for having a favorable impression of it (47%). Women were more concerned about side effects than were men, and they also knew more about the pill's potential side effects than did men. Only 12% of respondents said they intended to use the pill if it were approved. Roughly one-quarter (23-26%) did not correctly identify the pill's inability to protect against HIV and other sexually transmitted diseases (STDs). CONCLUSIONS: Legalization of oral contraceptives in Japan has led to an urgent need to educate both men and women on the inability of the pill to protect against STDs, including HIV Policymakers and providers need to recognize the importance of encouraging dual method use in Japan.     

Beliefs about high blood pressure prevention in a survey of blacks and Hispanics

Beliefs about the potential for high blood pressure prevention were assessed during a telephone survey of cardiovascular risk factor awareness among black and Hispanic adults in Chicago, Illinois. A high proportion of those interviewed-82% of blacks and 69% of Hispanics--thought a person could do something to prevent getting high blood pressure and either selected one or more of several possible preventive measures listed by the interviewer or volunteered other measures. Awareness of two widely cited prevention possibilities that may be particularly important for black and Hispanic populations--lowering salt intake and maintaining ideal weight--was low. Fewer than half of the respondents in this survey (44% of blacks and 26% of Hispanics) thought that lowering salt intake would help prevent high blood pressure. An even smaller number (10% of blacks and 20% of Hispanics) thought that maintaining ideal weight would help prevent high blood pressure. Moreover, other measures that are unrelated to high blood pressure or for which a relation to high blood pressure is not well established were selected frequently. These findings were contrary to our expectations, because black and Hispanic populations have been targeted by the National High Blood Pressure Education campaign and because high levels of awareness in other areas of cardiovascular disease risk were observed in this sample. These data suggest that awareness of potential strategies for high blood pressure prevention among black and Hispanic communities needs to be addressed specifically in related educational campaigns.