Effects of at‐risk drinking on central hemodynamics and aortic stiffness in midlife adults

The purpose of this cross-sectional study was to determine the effect of at-risk drinking on central hemodynamics and aortic stiffness in midlife adults. A total of 38 midlife men and 41 postmenopausal women, aged 50-64 and free of major clinical diseases, were included. Based on USAUDIT-C scores derived from the U.S. Alcohol Use Disorder Identification Test, participants were classified as low-risk drinkers (n = 50) or at-risk drinkers (n = 29). Central blood pressure (BP), aortic wave reflection indices, as well as carotid-to-femoral pulse wave velocity (cfPWV; a measure of aortic stiffness) were measured. Regardless of sex (p = 0.11 for both), among participants free of antihypertensive medications (n = 51), at-risk drinkers had higher central systolic (p = 0.002) and diastolic BP (p < 0.001) compared with low-risk drinkers, while there was no between-group difference in central BP among treated participants (n = 28; p ≥ 0.41). Among untreated participants, higher USAUDIT-C scores remained independently associated with elevated systolic (p < 0.001) and diastolic BP (p = 0.003), after controlling for wave reflection indices and cfPWV. Regardless of antihypertensive medication use (p ≥ 0.25) and sex (p ≥ 0.10), no between-group differences were observed in aortic wave reflection indices (p ≥ 0.18) and cfPWV (p = 0.16). These findings suggest that elevated central BP associated with at-risk drinking is related to mechanisms other than enhanced aortic wave reflection or aortic stiffening.