Blood pressure and pressor mechanisms during alcohol withdrawal.

Blood pressure, alcohol withdrawal symptoms and plasma levels of cortisol, aldosterone and renin activity and serum dopamine beta-hydroxylase concentrations were measured in 65 alcoholics on the first and fourth days after admission for detoxification. On the day after admission blood pressure was elevated (greater than 140/90 mmHg) in 32 patients (49%) and was 160/95 mmHg or more in 21 (32%). Plasma renin activity was elevated in 41 patients and plasma aldosterone concentration in 14, but neither correlated with blood pressure. Plasma cortisol levels were elevated in 13 patients and were positively correlated with systolic blood pressure. Blood pressure and all biochemical measures fell significantly by the fourth day while urine volume and sodium output, low on admission, increased significantly. Urinary metanephrine levels were elevated in four of 31 patients in whom they were measured on admission. Alcohol withdrawal was accompanied by raised blood pressure and high plasma concentrations of cortisol, renin and aldosterone but only plasma cortisol concentrations and withdrawal symptoms were significantly related to blood pressure.