in Pancreatic Insufficiency. Comparison of Two Dosage Schedules. New Engl. J. Med. 296: 131 8- 1322, 1977

3. D.Y. Graham: Enzyme Replacement Therapy of

Exocrine Pancreatic Insufficiency in Man. Rela- tion Between In Vitro Enzyme Activities and In Vivo Potency in Commercial Pancreatic Extracts. New Engl. J. Med. 296: 1314-1317, 1977

ALCOHOL CONSUMPTION AND BLOOD PRESSURE

The massive number of interviews conducted as a part of health checkup examinations between July, 1964, and August, 1968, in the Kaiser-Permanente Medical Care Program were used to relate alcohol consumption to blood pressure.’ Of 105,578 individuals who completed multiphasic screening, sufficient data on self-admitted alcohol consumption was available in 83,947 men and women from the ages of 15 to 79.

Drinking history in the past year indicated (a) nondrinkers, (b) those taking zero to two drinks each day, (c) three to five drinks or (d) more than six drinks each day of an alcoholic beverage. Because of the large number of sub- jects, age, sex, race, cigarette and coffee use, education level and adiposity could be evalu- ated in relation to drinking. When compared with nondrinkers, those taking six or more por- tions each day had strikingly significant eleva- tion of the systolic blood pressure (mean 10.9 mm Hg higher), and diastolic blood pressure (mean 4.5 mm Hg higher) in all groups. If signi- ficant hypertension is defined as blood pressure in excess of 160/95 in either level, then in com- paring drinkers with nondrinkers, the percent-

ages of persons with both systolic and diastolic “hypertension” were as follows: in white men 1 1.21 versus 4.7 percent is found, white women 11.3 versus 6.3 percent, black men 15.1 ver- sus 10.2 percent and black women 24.2 versus 14.7 percent.

The effect did not become significant in all of the sex and racial groups until more than two drinks were taken each day, suggesting that there may be a threshold effect. The effect was independent of age, sex, race, cigarette smoking, drinking of more than six cups of coffee per day or educational attainment. The authors reviewed this experience in terms of three other epidemiological studies and found the conclusions similar. In contrast to other studies, however, the significance of the eleva- tion seemed greater. Therefore this larger study supports heavy intake of alcohol as being of importance in clinically meaningful hyper- tension. 0

1. A.L. Klatsky, G.D. Friedman, A.B. Siegelaub and M.J. Gerard: Alcohol Consumption and Blood Pressure. New Engl. J. Med. 296: 1194-1200, 1977

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