Reducing Cardiovascular Risks: The Role of Alcohol Use

The overarching objective is to determine the effect of alcohol abstinence on cardiovascular disease risks in individuals who consume alcoholic beverages over the recommended limits. After baseline assessment, participants will be randomly assigned to receive one of the interventions: either continue their usual drinking habits or to abstain from alcohol drinking. Before and after the 8-week intervention, blood pressure and sub-clinical cardiovascular disease risk factors (including arterial stiffness, endothelial function, and sympathetic nerve activity) will be measured. A longitudinal assessment of objective sleep will be performed throughout the study participation. Participants will be asked to maintain their diet and physical activity throughout the study.

Inclusion criteria

• Men and women aged 26 to 49 years
• At-risk drinkers who drink over the recommended limits, defined as those with PEth (≥20 ng/dL) or those with a U.S. Alcohol Use Disorders Identification Test (USAUDIT) score ≥8/7 for men/women
• Elevated blood pressure or hypertension (systolic blood pressure: 120-160 mmHg and/or diastolic blood pressure 80-100 mmHg)

Exclusion criteria

• History of CVD or cardiovascular events (e.g., stroke, myocardial infarction)
• The presence of myocardial ischemia or arrhythmias with abnormal ECG and blood pressure during a clinically-supervised maximal graded exercise test
• Hypertension (systolic >160 mmHg and diastolic >100 mmHg)
• On more than one anti-hypertensive medication, or on other physician-prescribed medications (but not including oral contraceptives)
• Major psychiatric disorders, including autism, ADHD, bipolar disorder, major depression, schizophrenia, and substance use disorders
• Alcohol use disorder, PEth ≥400 ng/mL, or USAUDIT score ≥ 25
• Current or history of any tobacco use in the past 6 months (including, but not limited to, cigarettes, e-cigarettes, hookah, Nicorette, snus and chewing tobacco)
• Current or history of illicit and recreational drug use (more than 3 times in the past month and more than 15 times in their lifetime)
• Diabetes type 1 & type 2 with fasting blood glucose ≥126 mg/dL
• Presence of renal disease with a creatinine > 1.5 mg/dL
• Presence of liver disease with liver enzymes > 3x the upper limits of normal
• Anemia with a hemoglobin < 8 g/dL
• Diagnosis of chronic inflammatory disease such as, but not limited to, cancer
• Diagnosis of chronic autoimmune diseases such as, but not limited to lupus, multiple sclerosis, rheumatoid arthritis
• Diagnosis of chronic obstructive pulmonary disease, pulmonary fibrosis, pneumonia, lung cancer, and cystic fibrosis
• Diagnosis of neurological diseases, including seizure disorders, Alzheimer's disease, Parkinson's disease, multiple sclerosis, stroke, traumatic brain injury, and peripheral neuropathies
• Body mass index <18.5 or ≥40 kg/m2
• Unstable body weight (>5% change during the past 6 months)
• Obstructive sleep apnea
• Night-shift work
• Women who are pregnant (or intend to become pregnant while participating in study), breastfeeding, or postmenopausal