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Relationship between alcohol use, blood pressure and hypertension: an association study and a Mendelian randomisation study
  1. Pian-Pian Zhao1,
  2. Liang-Wen Xu2,
  3. Tao Sun3,
  4. Yin-Yin Wu2,
  5. Xiao-Wei Zhu1,
  6. Bo Zhang4,
  7. Zhi Cheng5,
  8. Xiao Cai2,
  9. Yu-Chao Liu2,
  10. Ting-Ting Zhao2,
  11. Ting-Ting Wu2,
  12. Hai-Yan Ma2,
  13. Li Wang2,
  14. Xing-Wei Zhang6,
  15. Lei Yang2,
  16. Hou-Feng Zheng1
  1. 1 Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University and Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
  2. 2 Division of Preventive Medicine, School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
  3. 3 Department of Pediatrics, Suzhou New Century International Children’s Hospital, Suzhou, Jiangsu, China
  4. 4 Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
  5. 5 Department of Pediatrics, Suzhou Science & Technology Town Hospital, and Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, Jiangsu, China
  6. 6 Department of Cardiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
  1. Correspondence to Dr Hou-Feng Zheng, Diseases & Population (DaP) Geninfo Lab, Westlake University and Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China; zhenghoufeng{at}; Professor Lei Yang; yanglei62{at}


Background Past studies have found a strong relationship between alcohol drinking and human health.

Methods In this study, we first tested the association of rs671 with alcohol use in 2349 participants in southeast China. We then evaluated the causal impact between alcohol use and cardiovascular traits through a Mendelian randomisation (MR) analysis.

Results We found strong evidence for the association of rs671 in the ALDH2 gene with alcohol drinking (p=6.08×10-47; ORadj G=4.50, 95% CI 3.67 to 5.52). We found that female G carriers of rs671 had a higher proportion of non-drinkers than male G carriers (88.01% vs 38.70%). In non-drinkers, the female G allele frequency was higher than the male G allele frequency (71.1% vs 55.2%). MR analysis suggested that alcohol use had a causal effect on blood pressure (increasing 9.46 mm Hg for systolic blood pressure (p=9.67×10-4) and 7.50 mm Hg for diastolic blood pressure (p=9.62×10-5)), and on hypertension in men (p=0.011; OR =1.19, 95% CI 1.04 to 1.36) and in pooled samples (p=0.013; OR =1.20, 95% CI 1.04 to 1.39), but not in women. We did not observe a causal effect of alcohol use on body mass index and lipid levels; further studies are needed to clarify the non-causal relationship.

Conclusions Compared to never-drinkers, current and previous alcohol use had a causal effect on blood pressure and hypertension in pooled samples and in men. These results reflect Chinese culture which does not encourage women to drink.

  • polymorphism
  • blood pressure
  • alcohol use
  • mendelian randomization
  • chinese population

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  • P-PZ, L-WX and TS are joint first authors.

  • LW, X-WZ, LY and H-FZ are joint senior authors.

  • Contributors Conceived and designed the study: H-FZ. Contributed materials: LY, L-WX, H-YM, Y-YW, LW, X-WZhu, XC, T-TW, T-TZ, Y-CL. Performed the experiments: P-PZ, X-WZhang, TS, ZC, BZ. Wrote the manuscript: H-FZ. All authors reviewed and approved the manuscript before submission.

  • Funding This work was supported by the Zhejiang Provincial Natural Science Foundation of China (LR17H070001 and LZ13H02001), and the National Natural Science Foundation of China (81871831). The funding agencies had no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript. We thank the peer reviewers for their thorough and helpful review of this manuscript.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon reasonable request.