Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
Rehm, Jürgen (Technische Universität Dresden)
Anderson, Peter (Maastricht University)
Prieto, Jose Angel (Primary Care Spanish Society SEMERGEN)
Armstrong, Iain (Health and Wellbeing Directorate. Public Health England)
Aubin, Henri-Jean (University Paris-Sud)
Bachmann, Michael (Copentown Healthcare Consultants)
Bastida Bastus, Nuria (Raval Nord)
Brotons, Carlos (Institut d'Investigació Biomèdica Sant Pau)
Burton, Robyn (Public Health England)
Cardoso, Mabnuel (General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD))
Colom, Joan (Generalitat de Catalunya)
Duprez, Daniel (University of Minnesota)
Gmel, Gerrit (University of New South Wales)
Gual, Antoni (Hospital Clínic i Provincial de Barcelona)
Kraus, Ludwig (Stockholm University)
Kreutz, Reinhold (Charité - Universitätsmedizin Berlin)
Liira, Helena (University of Helsinki)
Manthey, Jakob (Technische Universität Dresden)
Møller, Lars (WHO Regional Office for Europe)
Okruhlica, Lubomír (Centrum pre Liecbu Drogovych Zavislosti)
Roerecke, Michael (University of Toronto)
Scafato, Emanuele (Società Italiana di Alcologia (SIA))
Schulte, Bernd (Hamburg University)
Segura-Garcia, Lidia (Generalitat de Catalunya)
Shield, Kevin David (Institute for Mental Health Policy Research)
Sierra, Cristina (Hospital Clínic i Provincial de Barcelona)
Vyshinskiy, Konstantin (Federal Medical Research Centre for Psychiatry and Narcology n.a. V. Serbsky)
Wojnar, Marcin (Medical University of Warsaw)
Zarco, José (Ibiza Primary Health Care Center)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets. Methods: A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded. Results: Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries. Conclusions: The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Alcohol use ; Blood pressure ; Europe ; Hypertension ; Management ; Primary healthcare ; Recommendations ; Screening
Published in:	BMC Medicine, Vol. 15 Núm. 1 (28 2017) , p. 173, ISSN 1741-7015

DOI: 10.1186/s12916-017-0934-1
PMID: 28954635

10 p, 481.8 KB

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Articles > Research articles
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