Effect of alcohol withdrawal on blood pressure, plasma renin activity, aldosterone, cortisol and dopamine β-hydroxylase

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Abstract
Alcoholic patients (65) admitted for detoxification had blood pressure, withdrawal symptoms, plasma cortisol (PC) and plasma aldosterone (PA) levels, plasma renin activity (PRA) and serum dopamine .beta.-hydroxylase (DBH) levels measured on the 1st and 4th days after admission. On the morning after admission blood pressure was elevated (> 140/90) in 32 patients (49%) and was .gtoreq. 160/95 mm Hg in 21 (32%). PRA was initially elevated in 41 patients, PA levels in 14 and 13 patients had raised PC levels. By the 4th day, blood pressure and biochemical measures had fallen significantly while urine volume and Na output, low on admission, had increased significantly. On admission urinary metanephrine levels were raised in 4 of 31 patients who had them measured. The height of the systolic and diastolic blood pressures was significantly related to the severity of the alcohol withdrawal symptoms. Of the biochemical parameters measured, PC level correlated with systolic but not diastolic pressure, and urinary volume was inversely correlated with the height of the diastolic pressure. No relationship was found between blood pressure and PRA or PA level. The pressor effect of alcohol withdrawal could have been due to sympathetic nervous system overactivity, or possibly to hypercortisolemia. The 1st hypothesis seemed more likely.

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