***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Office blood pressure ( OBP ) , ambulatory blood pressure ( ABP ) , and vascular reactivity were measured in 12 normotensive ' social ' drinkers ( mean alcohol consumption of 9.7 + /- 3.1 g/day ) after 4 days of alcohol consumption  ( 1 g/kg/day ) and compared with the effects of an isocaloric substitute ( sucrose , 1.75 g/kg/day ) or no intervention . Alcohol consumption did not affect OBP or 24-mean ABP but appeared to decrease nocturnal systolic and diastolic blood pressure soon after consumption . Although vascular reactivity did not differ between the groups , the blood pressure rise in response to isometric exercise tended to be lower following alcohol . Thus , short-term alcohol ingestion by normotensive ' social ' drinkers does not increase office or ambulatory blood pressure A direct pressor effect of alcohol is proposed as the basis for the association between regular alcohol consumption and an increase in blood pressure found in population studies . To examine this further , a r and omized controlled crossover trial of the effects of varying alcohol intake on blood pressure in 46 healthy male drinkers was conducted . From an average of 336 ml of ethanol per week , alcohol consumption was reduced by 80 % for 6 weeks by drinking a low alcohol content beer alone . This reduction was associated with a significant reduction in systolic and diastolic blood pressure ( p less than 0.001 and p less than 0.05 respectively ) . The mean difference in supine systolic blood pressure during the last 2 weeks of normal or low alcohol intake was 3.8 mm Hg , which correlated significantly with change in alcohol consumption ( r = 0.53 , p less than 0.001 ) . Reduction of alcohol intake also caused a significant decrease in weight ( p less than 0.001 ) . After adjustment for weight change , an independent effect of alcohol on systolic but not diastolic blood pressure was still evident , with a 3.1 mm Hg fall predicted for a decrease in consumption from 350 ml of ethanol equivalent per week to 70 ml per week ( p less than 0.01 ) . Systolic blood pressure rose again when normal drinking habits were resumed . These results provide clear evidence for a direct and reversible pressor effect of regular moderate alcohol consumption in normotensive men and suggest that alcohol may play a major role in the genesis of early stages of blood pressure elevation The effect of alcohol on blood-pressure was studied in 16 men with hypertension who regularly drank up to 80 g of alcohol daily .  Antihypertensive treatment was stopped 2 weeks before the men were admitted to hospital for a 7-day study . Blood pressure remained high in 8 patients who continued their regular alcohol consumption up to the fourth day after admission . In the next 4 days no alcohol was taken and diastolic and systolic blood pressures fell significantly . 8 other patients had no alcohol for the first 3 days after admission , but they resumed alcohol consumption from day 4 to 7 . In these patients , blood pressure fell slightly after admission . Re introduction of alcohol produced statistically significant increases in both systolic and diastolic pressures . This study demonstrated a pressor effect of alcohol in patients with hypertension and confirms the link between alcohol and blood-pressure reported in population studies . The mechanism of alcohol-induced hypertension is uncertain and is more likely to be due to an effect of alcohol rather than to the pressor response produced by alcohol withdrawal Fifty-four untreated , mildly hypertensive men whose daily alcohol consumption was > or = 28 ml ethanol and who drank at least 4 times per week took part in a r and omized , controlled crossover trial . The purpose of the trial was to test the effects of alcohol reduction on blood pressure . After a 2-week familiarization period , the participants were assigned to either a reduced alcohol drinking group or a usual drinking group for 3 weeks ( experimental period 1 ) . The situation was then reversed for the next 3 weeks ( experimental period 2 ) . The participants were requested to limit their daily alcohol consumption to zero or reduce it as much as possible for the reduced alcohol consumption period . The self-reported alcohol consumption was 56.1 + /- 3.6 ( SEM ) ml/day during the usual alcohol drinking period and 26.1 + /- 3.0 ml/day during the period of reduced alcohol consumption . Systolic and diastolic blood pressures in the intervention group were found by analysis of variance to be significantly lower ( 2.6 - 4.8 and 2.2 - 3.0 mm Hg , respectively ) than those in the control group during experimental period 2 for systolic blood pressure and experimental period 1 for diastolic blood pressure . Significant ( 3.6 mm Hg ) and nonsignificant ( 1.9 mm Hg ) decreases in systolic and diastolic blood pressure , respectively , were observed . The method of Hills and Armitage was used , reducing ethanol in daily alcohol consumption by 28 ml . The lowering effect of reduced alcohol consumption on blood pressure was independent of changes in salt consumption , which were estimated by 24-hour urine collection and body weight . ( ABSTRACT TRUNCATED AT 250 WORDS 44 men with treated essential hypertension who were moderate to heavy drinkers took part in a r and omised , controlled , crossover trial of the effects of alcohol intake on blood pressure .  Usual antihypertensive treatment was maintained throughout 6 weeks of normal drinking and 6 weeks of drinking only a low-alcohol beer . Self-reported changes in alcohol consumption ( mean [ SEM ] from 452 [ 30 ] ml ethanol/week during normal drinking to 64 [ 8 ] ml/week while drinking the low-alcohol beer ) were confirmed by biochemical measurements . Mean systolic and diastolic blood pressures were significantly lower during the last 2 weeks of the low-alcohol period than during the normal-alcohol period , the mean difference in the supine readings being 5.0 ( 1.4 ) and 3.0 ( 0.9 ) mm Hg , respectively . Regression analysis suggested that reduction in alcohol intake contributed to the fall in both systolic and diastolic blood pressures independently of changes in weight . Thus , curtailing alcohol intake may lead to improved blood-pressure control and may reduce the need for antihypertensive drugs The vasodilation that follows acute alcohol intake is hard to conciliate with the high prevalence of hypertension detected in those persons who consume regular amounts of alcohol . In this experiment we examined early and late hemodynamic effects of acute administration of water and of 15 g , 30 g , and 60 g of alcohol in 40 normal men , aged 19 to 30 years , using 24-h ambulatory blood pressure monitoring ( ABPM ) .  Mean systolic and diastolic blood pressures were each approximately 4 mm Hg lower during the period immediately after ingestion of 60 g ( v 0 g ) of ethanol , and were 7 and 4 mm Hg higher , respectively , at night . The day minus night differences displayed a dose-response curve both for systolic ( P < .001 ) and diastolic blood pressure ( P = .045 ) . Three subjects in the 60-g group had more than 50 % of nightly blood pressure loads in the hypertensive range against none in the remaining groups ( P < .01 ) . In conclusion , our findings suggest that acute alcohol intake elicits a biphasic hemodynamic response , causing , first , vasodilatation and , later , a pressor effect . The higher prevalence of  hypertension  in alcohol abusers seen in epidemiological surveys may be , in part , a result of measurements done in the period of transiently increased blood pressure during ethanol washout PURPOSE Restriction of alcohol intake is widely recommended in the treatment of hypertension . However , we have observed that alcohol may have biphasic effects on blood pressure in Japanese men with hypertension . METHODS Hypertensive men ( n = 34 ) who habitually drank alcohol were r and omly assigned to keep their drinking habits constant for 4 weeks , or to abstain ( or reduce alcohol intake to a maximum of 15 mL/day ) for 4 weeks in a crossover design . Amount of alcohol intake was recorded by each patient throughout the study . Office and 24-hour ambulatory blood pressure were measured at the end of both periods . RESULTS After alcohol restriction , mean ( + /-SD ) ethanol intake decreased from 66+/-26 mL/day to 11+/-10 mL/day . Office systolic blood pressure decreased slightly from 142+/-12 mm Hg to 139+/-11 mm Hg , and diastolic blood pressure decreased significantly from 95+/-7 mm Hg to 93+/-7 mm Hg in the low-alcohol period . Daytime systolic blood pressure fell by 3+/-9 mm Hg ( P < 0.05 ) , but nighttime systolic blood pressure rose by 4+/-9 mm Hg ( P < 0.05 ) with restriction of alcohol intake . Thus , average 24-hour blood pressure did not change , although 24-hour heart rate and day-night difference in blood pressure decreased significantly in the low-alcohol period . CONCLUSION In Asian men with hypertension , restriction of alcohol intake reduces daytime blood pressure but not night-time or 24-hour blood pressure Ten normal volunteers consumed 80 g of ethanol per day or abstained from ethanol for 4 consecutive days prior to measurements of blood pressure , heart rate , vascular responsiveness to noradrenaline ( NA ) and angiotensin II ( AII ) infusions  and sympathetic responsiveness to isometric h and grip exercise in an open , r and om order , crossed study . Supine systolic and diastolic pressures and heart rates , and erect systolic pressures rose significantly following ethanol .  Vascular responsiveness to NA infusions was reduced in all subjects following ethanol , while responses to AII infusions did not show a consistent pattern of change . Plasma renin activity , plasma NA and adrenaline concentrations , and concentrations of the NA metabolite 3,4 dihydroxyphenylethylene glycol ( DHPG ) did not significantly differ following ethanol and control treatments . The rise in plasma NA following 2 min isometric h and grip at 50 % of maximal effort was greater following ethanol ( 0.24 + /- 0.21 nM ) than control ( 0.12 + /- 0.10 nM ) but the difference did not reach statistical significance . The pressor effect of regular ethanol consumption and the reduced vascular reactivity to NA may both be the result of an increase in sympathetic activity that was not large enough to measurably alter resting plasma NA concentrations 1 . Forty‐four males with treated essential hypertension and a moderate‐to‐heavy alcohol intake participated in a r and omized controlled crossover trial of the effects of varying alcohol intake on blood pressure control . Usual antihypertensive therapy  was maintained unchanged throughout Objectives The International Nifedipine GITS Study Intervention as a Goal in Hypertension Treatment ( INSIGHT ) showed , by means of office blood pressure measurements , that long-term treatment with nifedipine GITS is as effective as diuretics in preventing cardiovascular and cerebrovascular complications . However , since office blood pressure measurements reflect to a limited extent blood pressure outside the office , a side-arm INSIGHT study in which patients underwent both office measurement and 24 h ambulatory blood pressure monitoring was also performed . Design and methods The study had a r and omized , double-blind , parallel group design . After 4 weeks of placebo , mild-to-moderate essential hypertensive patients were r and omized to nifedipine GITS 30 mg or amiloride 2.5 + hydrochlorothiazide  5 mg for 3.1 years . Dose titration was performed by dose doubling and addition of atenolol 25–50 mg or enalapril 5–10 mg , or other drugs when needed . Analysis was carried out by intention-to-treat and included computation of 24 h , day and night ambulatory blood pressure and heart rate values . Additional analyses included computation of the trough-to-peak ratio and the smoothness index ( the ratio between the average of the 24-hourly blood pressure reductions after treatment and its st and ard deviation ) . Results A total of 151 patients were recruited and 149 were valid for analysis : 78 patients had 24 h ambulatory recordings both at baseline and during treatment and 134 during treatment . Office , 24 h and day and night blood pressures were all significantly and similarly reduced by both treatments . Office and ambulatory heart rate was left unchanged by diuretics , while it was slightly reduced by nifedipine . Median trough-to-peak ratios were always > 0.5 and superimposable between the two treatment groups . Similarly , smoothness indices of systolic and diastolic blood pressures were comparably high for nifedipine and diuretics , thus demonstrating a similar well-balanced antihypertensive response to both drugs . No significant differences were observed between the two treatment groups in the number of cardiovascular events ( 17 in the nifedipine-based and 26 in the diuretics-based treatment group ) . Conclusions In the INSIGHT study , the long-term antihypertensive effect on 24 h blood pressure and the cardiovascular protection of nifedipine was similar to that of diuretics Background and aims The Hypertension Optimal Treatment ( HOT ) study showed that when antihypertensive treatment reduces diastolic blood pressure well below 90 mmHg , there can be a further reduction of cardiovascular events , particularly myocardial infa rct ion , with no evidence of a J-shaped curve at lower pressures . Office measurement , however , gives no information about blood pressure outside 
    Output:
    
An early effect of alcohol leading to a reduction BP ( in the hours after exposure ) and a later effect ( next day ) of raising BP led to smaller differences in the net effect of alcohol on BP when ambulatory BP monitoring measurements were compared with casual office- or clinic-based measurements .
These findings indicate that the timing of BP measurements after alcohol intake has a substantial effect on the magnitude and perhaps even the direction of BP change