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Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union

BACKGROUND: 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...

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Autores principales: Rehm, Jürgen, Anderson, Peter, Prieto, Jose Angel Arbesu, Armstrong, Iain, Aubin, Henri-Jean, Bachmann, Michael, Bastus, Nuria Bastida, Brotons, Carlos, Burton, Robyn, Cardoso, Manuel, Colom, Joan, Duprez, Daniel, Gmel, Gerrit, Gual, Antoni, Kraus, Ludwig, Kreutz, Reinhold, Liira, Helena, Manthey, Jakob, Møller, Lars, Okruhlica, Ľubomír, Roerecke, Michael, Scafato, Emanuele, Schulte, Bernd, Segura-Garcia, Lidia, Shield, Kevin David, Sierra, Cristina, Vyshinskiy, Konstantin, Wojnar, Marcin, Zarco, José
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618725/
https://www.ncbi.nlm.nih.gov/pubmed/28954635
http://dx.doi.org/10.1186/s12916-017-0934-1
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author Rehm, Jürgen
Anderson, Peter
Prieto, Jose Angel Arbesu
Armstrong, Iain
Aubin, Henri-Jean
Bachmann, Michael
Bastus, Nuria Bastida
Brotons, Carlos
Burton, Robyn
Cardoso, Manuel
Colom, Joan
Duprez, Daniel
Gmel, Gerrit
Gual, Antoni
Kraus, Ludwig
Kreutz, Reinhold
Liira, Helena
Manthey, Jakob
Møller, Lars
Okruhlica, Ľubomír
Roerecke, Michael
Scafato, Emanuele
Schulte, Bernd
Segura-Garcia, Lidia
Shield, Kevin David
Sierra, Cristina
Vyshinskiy, Konstantin
Wojnar, Marcin
Zarco, José
author_facet Rehm, Jürgen
Anderson, Peter
Prieto, Jose Angel Arbesu
Armstrong, Iain
Aubin, Henri-Jean
Bachmann, Michael
Bastus, Nuria Bastida
Brotons, Carlos
Burton, Robyn
Cardoso, Manuel
Colom, Joan
Duprez, Daniel
Gmel, Gerrit
Gual, Antoni
Kraus, Ludwig
Kreutz, Reinhold
Liira, Helena
Manthey, Jakob
Møller, Lars
Okruhlica, Ľubomír
Roerecke, Michael
Scafato, Emanuele
Schulte, Bernd
Segura-Garcia, Lidia
Shield, Kevin David
Sierra, Cristina
Vyshinskiy, Konstantin
Wojnar, Marcin
Zarco, José
author_sort Rehm, Jürgen
collection PubMed
description BACKGROUND: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-017-0934-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-56187252017-10-03 Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union Rehm, Jürgen Anderson, Peter Prieto, Jose Angel Arbesu Armstrong, Iain Aubin, Henri-Jean Bachmann, Michael Bastus, Nuria Bastida Brotons, Carlos Burton, Robyn Cardoso, Manuel Colom, Joan Duprez, Daniel Gmel, Gerrit Gual, Antoni Kraus, Ludwig Kreutz, Reinhold Liira, Helena Manthey, Jakob Møller, Lars Okruhlica, Ľubomír Roerecke, Michael Scafato, Emanuele Schulte, Bernd Segura-Garcia, Lidia Shield, Kevin David Sierra, Cristina Vyshinskiy, Konstantin Wojnar, Marcin Zarco, José BMC Med Guideline BACKGROUND: 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-017-0934-1) contains supplementary material, which is available to authorized users. BioMed Central 2017-09-28 /pmc/articles/PMC5618725/ /pubmed/28954635 http://dx.doi.org/10.1186/s12916-017-0934-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Guideline
Rehm, Jürgen
Anderson, Peter
Prieto, Jose Angel Arbesu
Armstrong, Iain
Aubin, Henri-Jean
Bachmann, Michael
Bastus, Nuria Bastida
Brotons, Carlos
Burton, Robyn
Cardoso, Manuel
Colom, Joan
Duprez, Daniel
Gmel, Gerrit
Gual, Antoni
Kraus, Ludwig
Kreutz, Reinhold
Liira, Helena
Manthey, Jakob
Møller, Lars
Okruhlica, Ľubomír
Roerecke, Michael
Scafato, Emanuele
Schulte, Bernd
Segura-Garcia, Lidia
Shield, Kevin David
Sierra, Cristina
Vyshinskiy, Konstantin
Wojnar, Marcin
Zarco, José
Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title_full Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title_fullStr Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title_full_unstemmed Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title_short Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union
title_sort towards new recommendations to reduce the burden of alcohol-induced hypertension in the european union
topic Guideline
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618725/
https://www.ncbi.nlm.nih.gov/pubmed/28954635
http://dx.doi.org/10.1186/s12916-017-0934-1
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