How just 1 alcoholic drink a day can impact blood pressure
How just 1 alcoholic drink a day can impact blood pressure
Dr. Payal Kohli discusses a new study showing how just one drink a day can raise blood pressure and harm overall health.\r
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Content
0 -> [Music]
0.84 -> thanks for joining us on 90s plus I'm
3.06 -> Chris Young well we all probably knew
6.24 -> that alcohol is bad for you but there
8.4 -> are some indications it may actually be
10.38 -> worse for us than previously thought
12.66 -> specifically there's a new study with
14.82 -> almost 20 000 participants in it that
17.279 -> found that just one alcoholic drink a
19.74 -> day could raise a person's blood
22.26 -> pressure and there may be evidence that
24.3 -> again Lower amounts of alcohol than
26.58 -> previously thought could increase your
28.5 -> blood pressure and sorry to be the
30.359 -> bearer of bad news on that one I'll
31.679 -> admit I often have a drink or two at
34.2 -> night but let's talk through this with
36.3 -> our nine use medical expert Dr Pyle
38.1 -> Cooley
39.239 -> um Dr Coley it seems that even those
41.46 -> lower amounts of alcohol could have a
42.96 -> bad impact on our health right Chris
44.7 -> that's what's really provocative about
46.26 -> this study is it's really questioning
48.12 -> this this adage for a long time we've
50.34 -> said oh one drink for a woman two drinks
52.2 -> for a man a day seems to be okay in fact
54.239 -> the American Heart Association and the
56.1 -> cancer societies many of those in the
57.719 -> United States recommend those as the
59.579 -> guidelines but this is is now telling us
61.86 -> oh it's part of a growing body of
63.96 -> literature that's telling us that no
65.519 -> amount of alcohol appears safe and even
67.92 -> the amounts that we previously thought
69.299 -> were sort of moderate amounts could
71.46 -> actually be creating adverse effects in
73.439 -> our cardio metabolic parameters such as
75.119 -> blood pressure which could be impacting
77.88 -> increased risk of heart disease and and
79.979 -> what's interesting is that there's a
81.479 -> dose-dependent relationship so it seems
83.46 -> to be that the more you drink the more
85.32 -> that blood pressure is likely to go up
87.119 -> the top number is affected in both men
89.82 -> and women and we're really wondering if
91.92 -> this is one of the mechanisms by which
93.6 -> alcohol confers a higher risk of heart
95.7 -> disease and heart disease morbidity and
97.979 -> mortality and I often see patients in my
100.38 -> clinic and believe it or not I can
101.759 -> actually tell if they've had a drink or
103.38 -> two the night before based on what their
105.659 -> blood pressure looks like we also can
107.22 -> see similar things when they go out to
108.6 -> eat and so often I can kind of spy on
111.06 -> people's behavior based on their blood
113.159 -> pressure and and I think what that
115.799 -> really brings to light is the fact that
117.42 -> so much of our health is determined by
119.34 -> our behaviors more so than and we've
121.32 -> previously thought wow so you said that
124.38 -> you've seen it in some of your patients
126 -> were you then surprised or Not by this
128.94 -> study I was not surprised honestly and I
131.819 -> feel like we need more studies like this
133.56 -> where we are following people to to see
135.36 -> some of their behaviors to try to
136.68 -> understand the effects of even moderate
138.239 -> amount of alcohol because it's become
140.04 -> such a big part of our culture it's part
142.319 -> of our relaxation culture it's part of
143.94 -> our social culture it's part of our
145.56 -> celebratory culture you know special
147.18 -> offense weddings graduations we drink we
150.3 -> do have a toast here or there and where
152.4 -> that inflection point is in terms of
154.26 -> dose and risk has really become a moving
157.08 -> Target many of the international
158.459 -> societies like Canada for example have
161.76 -> actually now revised their guidelines
163.2 -> based on some of these new studies where
165.72 -> the number of safe drinks to consume is
167.58 -> no more than two per week which is
170.28 -> dramatically different from where we are
172.26 -> in the United States somewhere between 7
174.12 -> to 14 a week depending on your gender so
176.94 -> I often tell my patients when you have a
178.68 -> drink or two the next day the body even
180.239 -> sort of goes into a little bit about
181.739 -> alcohol withdrawal response and it can
184.44 -> acutely raise your blood pressure this
186.54 -> study tells us it's not just acute it
188.28 -> actually happens over a longer period of
190.5 -> time and it's the equivalent to eating
193.08 -> lots of sodium now salt we know is
194.94 -> linked to high blood pressure and we've
196.56 -> kind of spread that message but the
198.9 -> alcohol message I think has not been
200.76 -> quite as clear and it raises the top and
203.22 -> the bottom number in men now
204.84 -> interestingly in women we only see the
206.7 -> top number going up not as much the
208.8 -> bottom number going up so that also
211.319 -> points to some gender differences in how
213.239 -> women and men might respond differently
215.34 -> to alcohol maybe a recommendations ought
217.5 -> to be personalized for those two genders
220.14 -> yeah it's like I want to hear a bit more
221.879 -> about the gender specific differences
224.159 -> here and what the study says I mentioned
226.799 -> there was almost about 20 000
228.78 -> participants across the world within
230.519 -> this what do we find out from the gender
232.98 -> differences well there's another study
234.54 -> that actually looked at Women's specific
236.159 -> mortality and so men in general die more
238.68 -> from alcohol-related death right
241.319 -> um but women are catching up and that's
243.599 -> the part of it is like it's like the
245.28 -> rate of mortality growth in women is
247.62 -> higher so we're bridging what's called a
249.42 -> gender gap where it used to be more men
250.86 -> die of alcohol-related deaths than women
252.599 -> and part of that we think is lack of
255 -> education and awareness among women in
257.519 -> terms of how alcohol affects their body
259.32 -> and what a safe dose of alcohol might be
262.019 -> so if you think about a woman's body
263.699 -> size it's much smaller than a man's body
266.16 -> size so that's called the volume of
267.96 -> distribution so one drink in a woman is
270.54 -> going to lead to a higher blood
271.8 -> concentration of alcohol than it would
274.259 -> in a man and then on top of that there's
276.78 -> an enzyme called alcohol dehydrogenase
278.94 -> This Is A protein that breaks down
280.44 -> alcohol metabolizes it kind of helps to
283.02 -> get rid of it women generally tend to
285.06 -> have lower levels of alcohol
286.34 -> dehydrogenase there's also some racial
288.36 -> differences sometimes if you've heard of
289.86 -> what's called an Asian flush that can
292.259 -> happen certain races like Asians can
294.3 -> have lower levels of alcohol
295.52 -> dehydrogenase as well so essentially
297.66 -> this toxic carcinogenic substance that
300.3 -> you're consuming lingers longer to cause
303.66 -> effects longer so the exposure to the
306.24 -> toxic substance is really longer if you
308.1 -> have less of the enzyme that breaks it
309.84 -> down as efficiently so some of that is
312.479 -> what we're learning also there might be
313.86 -> differences in premenopausal and
315.56 -> post-menopausal women and their response
317.94 -> to alcohol especially with respect to
320.22 -> their blood pressure because we know
321.479 -> that estrogen plays a big role in your
324.18 -> your blood vessel tone in your blood
326.28 -> pressure in the inflammation in your
328.38 -> body many of the things that are also
329.94 -> kind of co-mingled with alcohol so when
331.919 -> you lose your estrogen after menopause
333.9 -> does it then affect your body
335.52 -> differently so really what we're hoping
337.199 -> is cardiologists and Physicians is to
339.06 -> try to increase awareness especially
340.5 -> among women that they're smaller they
343.32 -> need to be a little bit more careful
344.4 -> with the dose of alcohol because they
345.84 -> may have less of that enzyme their body
347.759 -> May react differently to the exact same
349.62 -> stressor so their hormonal influences on
353.639 -> how our body reacts to the exact same
355.32 -> stressor so man who drinks alcohol might
357.18 -> have a different blood vessel response
359.039 -> than a woman who drinks out alcohol and
361.56 -> this is not just for blood pressure but
363.06 -> also for arteries getting clogged and we
365.82 -> know similarly even things like
367.259 -> environmental pollution men and women
368.82 -> can actually respond differently so all
371.1 -> of those put together just kind of to me
373.02 -> says we need a lot more research around
375.24 -> the substance that we've is legalized is
379.08 -> normalized is part of our everyday
381.12 -> culture and something that we sort of
382.74 -> consume freely should we be starting to
385.199 -> think about alcohol the way we now think
386.94 -> about cigarettes that we have to be
388.919 -> really careful and and try to see if any
391.62 -> amount of alcohol is safe for us to use
393.74 -> should we be thinking about it that
396.3 -> harshly well I think we're not quite
397.86 -> there yet but I would say that don't
400.139 -> start drinking alcohol for health
401.759 -> benefits so there's a lot often times I
403.62 -> hear as a cardiologist should I have a
405.3 -> glass of wine because it's good for my
406.68 -> heart and what have you many of those
408.479 -> prior studies were actually confounded
410.4 -> in other words they were they were
412.38 -> comparing heavy drinkers to light
413.819 -> Drinkers and they're saying oh light
415.5 -> drinking is better than heavy drinking
417 -> and and there may be some positive
418.919 -> components to drinking a glass glass of
421.139 -> wine but that's that's far outweighed by
424.02 -> the risks conferred by alcohol so what
426.84 -> we're realizing is that no amount of
428.52 -> alcohol is recommended a small amount of
432.24 -> alcohol meaning one or two drinks a week
434.6 -> might be okay might be within the level
437.039 -> of being safe but that inflection point
439.5 -> where the risk of cancer the risk of
441.12 -> liver disease heart disease stomach
443.22 -> cancer all kinds of things starts to go
445.259 -> up maybe a lot lower than what we
447.539 -> actually thought so it might be in that
448.8 -> kind of previously thought to be
450.06 -> moderate range but you know doesn't have
453.84 -> to necessarily be excessive drinking
455.88 -> that potentially starts to confer that
458.16 -> risk I think maybe one of the top line
460.08 -> takeaways you mentioned some of those
461.639 -> cultural aspects of this I think it is
464.039 -> common in American society in many
467.639 -> societies to have a drink after work
470.28 -> yeah and it's not even to necessarily
473.099 -> get drunk I party on the weekend this is
475.319 -> just a I don't know ease the drink or
477.78 -> ease the stress after work perhaps kind
479.52 -> of thing
480.419 -> is this study kind of directly
482.539 -> confounding that yes especially for
485.039 -> somebody who has a predisposition for
486.72 -> high blood pressure if you're in that
487.979 -> pre-hypertension or elevated blood
489.72 -> pressure range this is going to push you
491.58 -> over the edge now we haven't talked even
493.08 -> about the other studies looking at
494.46 -> alcohol and sleep but we also know that
497.039 -> alcohol can profoundly disturb your
498.78 -> sleep patterns affect the quality of
501 -> your sleep effect obviously the quantity
502.56 -> of your sleep it might help you fall
503.94 -> asleep faster but the type of sleep
506.4 -> you're getting is not as restorative and
508.259 -> as restful the effects of alcohol and
510.479 -> inflammation I mentioned cancer there's
513.3 -> so many different things that alcohol
514.68 -> can affect that I think we need to start
516.899 -> to dissociate that positive relationship
519.659 -> of a drink after work is how I relax
522.38 -> from alcohol now if you want to have a
524.82 -> drink after work maybe you could have a
526.38 -> nice juice refresher or you could have a
528.6 -> non-alcoholic beer because I think a lot
531.18 -> of those effects are coming from the
533.04 -> ritual itself rather than necessarily
535.98 -> the actual alcohol substance in it and
538.019 -> not not to mention that many of those
539.519 -> alcoholic drinks are of calories and so
542.04 -> they can help you gain weight and you
543.779 -> know obesity is already a problem that
545.339 -> we're battling in America so I feel like
546.899 -> if you are very thoughtful about what
549.72 -> types of things about the alcoholic
552.42 -> um ritual make you feel good for example
554.82 -> if you meet your friends out does it
556.8 -> have to be for alcohol could it be for a
558.36 -> cup of coffee you know does it have to
560.519 -> necessarily be around a drink or could
562.26 -> you go for a walk in the park there are
563.88 -> ways in which you can incorporate more
566.279 -> healthier choices I think into some of
569.1 -> those social routines that we do so I
571.32 -> think this study to me is thought
572.7 -> provoking and helps me to start thinking
574.8 -> about doing that so that I don't just
576.959 -> think oh one drink a day say for women
578.76 -> and two drinks a day safe for men but
581.04 -> really I start to say how little alcohol
582.66 -> can I drink and still get that same kind
584.82 -> of enjoyment out of my social
586.08 -> relationships my professional
587.519 -> relationships and what have you and and
590.22 -> I don't want to scare people because
591.48 -> it's not necessarily like they're you
593.519 -> know something bad is going to happen if
594.899 -> you cross more than two or three drinks
596.459 -> but at the same time I don't think we
598.5 -> should normalize it as much as we've
600.12 -> done and what these kinds of studies
602.22 -> tell us is just like the Canadians is it
604.019 -> time to start to look again at our
605.88 -> guidelines and I suspect that's what's
608.22 -> going to happen in the next year or two
609.54 -> we're going to get some revised
610.86 -> guidelines on what healthy amounts of
613.44 -> alcohol consumption look like what do
615.6 -> you think those could look like probably
617.399 -> one or two a week one or two a week yes
619.38 -> yeah wow yeah for most most individuals
622.26 -> I'll just say that you know I'll say
624.54 -> this is a quick story is that my parents
627 -> both didn't drink growing up they still
629.22 -> don't yeah um and I say that to say that
631.86 -> one of the things my dad always told me
633.66 -> was that if your job requires you to
637.019 -> have a drink after work quit that job I
639.839 -> I say that to say that maybe this is
642.12 -> what you were saying about the
643.08 -> normalized culture of you know take the
645.36 -> edge off a little bit go to happy hour
647.1 -> right
648.36 -> um you know maybe that that is the part
650.94 -> of this that needs to be actively fought
652.62 -> right exactly now of course you know
654.779 -> those types of things have psychological
656.76 -> benefits so I still want to hold on to
658.5 -> those benefits but does it necessarily
660.54 -> have have to be tied around alcohol
662.1 -> that's the part of it I want us to start
663.959 -> to question actively because we're
665.94 -> becoming more conscious about our health
667.38 -> we're becoming you know
669.66 -> educated consumers of information and so
672.779 -> studies like this to me if if I could
675.66 -> change my drinking behavior and it could
677.7 -> prevent me from getting on a blood
679.019 -> pressure medicine for the rest of my
680.519 -> life when we know blood pressure is
681.959 -> leading cause of heart disease death in
684 -> the United States silent killer as we
686.04 -> call it that's a good trade-off you know
688.68 -> so if we have if we're armed with that
690.3 -> knowledge we can perhaps use the Empower
692.22 -> ourselves to change our Behavior a
694.38 -> little bit and every person situation
696.24 -> looks different so we really want you to
698.88 -> to feel free to bring this up to your
700.56 -> doctor and talk to them about these
702.06 -> studies talk to them about you know the
704.04 -> risk in post-menopausal women talk to
706.019 -> them about the dose-dependent
707.399 -> relationship risk if you're somebody
708.42 -> already with hypertension you know is
710.88 -> that two drinks a week is that still the
712.86 -> right number for you those are all the
714.24 -> things to discuss with your doctor and
716.76 -> and really try to help understand how
718.5 -> you can make a personalized plan for
720.42 -> yourself again if your sleep is
722.579 -> Disturbed you think you're taking the
724.14 -> ant off you think you're doing a good
725.459 -> job but you actually wake up feeling a
727.68 -> little bit hungover the next day and
729.959 -> that's because you didn't get good
730.98 -> quality of sleep and there's still too
732.3 -> much alcohol lingering in your
733.5 -> bloodstream and what have you so so I
735.779 -> think it helps us to think about more
737.82 -> mindfully what we're doing with our
739.44 -> alcohol consumption behaviors just think
741.48 -> about each drink I think that's that top
743.339 -> one takeaway any final thoughts anything
745.079 -> on this I just think we need more
747.3 -> studies like this Chris not just an
749.04 -> alcohol whether it comes to marijuana
750.6 -> whether it comes to Coffee there are a
752.339 -> lot of things that we do in our
753.48 -> day-to-day life that that we don't stop
755.76 -> to spend a lot of time thinking about
757.56 -> and I like the idea of these kind of
759.6 -> large longitudinal studies because they
762.24 -> start to give us a little bit of insight
763.92 -> into you know how things are now I'll
766.139 -> say one last thing which is also that
767.7 -> unless you randomize somebody that you
770.279 -> drink alcohol and you don't everything
772.2 -> else is the same you can get what's
774.36 -> called confounding which means that
776.639 -> maybe the people that are drinking more
778.2 -> alcohol are also eating a little bit
779.82 -> more salt and are also doing other
781.92 -> things because alcohol is often consumed
783.839 -> in a restaurant setting or what have you
785.399 -> so they may be doing other types of
786.959 -> behaviors or they're less active and
789.3 -> more sedentary what have you that could
791.1 -> also be causing some of these high blood
792.66 -> pressure signals and some of this
793.92 -> increased mortality and all the things
795.42 -> that we see so it's this is an
798 -> association not a causation with the
800.459 -> alcohol but knowing the mechanisms of
802.98 -> alcohol I wouldn't be surprised if it
804.779 -> turned into a causation because we know
806.279 -> in animal models these kinds of studies
808.5 -> can result in increased blood pressure
810.48 -> increased weight gain adverse metabolic
812.94 -> parameters you know obviously cancer
814.5 -> heart disease all those things with
816.06 -> alcohol use yeah you're usually not
817.92 -> having a fruit and salad at the bar
819.42 -> that's right with your gin and tonic
822.42 -> yeah
823.639 -> Dr koi fascinating study and fascinating
826.32 -> Insight thanks so much for joining us
827.339 -> here on 90s plus tonight thank you Chris
Source: https://www.youtube.com/watch?v=nHuIB2yq194