Reducing Cardiovascular Risks: The Role of Alcohol Use

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