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Moderate drinking linked to lower risk of heart failure

Impact seems to be greater for men than women having seven drinks a week

Caroline White

Tuesday, 20 January 2015

Moderate alcohol consumption in early to middle age is linked to a lower risk of developing heart failure in later life, finds a large study*, published in the European Heart Journal.

Moderate alcohol consumption has been linked to a lower risk of several heart conditions, but whether this extends to heart failure is not clear.

Over 23 million people around the globe have heart failure, which can develop as a result of damage to the heart muscle, high blood pressure, heart muscle disease, faulty heart valves, arrhythmia, viral infections, radiotherapy, excess alcohol, and recreational drugs.

Scott Solomon and colleagues analysed data from 14,629 people aged between 45 and 64 years who had been recruited to the Atherosclerosis Risk in Communities Study between 1987 and 1989 in the USA.

Their heart health was monitored for up to 25 years to the end of 2011, and they were asked about their typical alcohol consumption at the start and at each of the three subsequent visits made at three-yearly intervals.

A drink was defined as 14 g of alcohol, equivalent to approximately one small (125ml) glass of wine, just over half a pint of beer, and less than one shot of spirits such as whisky or vodka.

Study participants were divided into six categories of drinking patterns: abstainers; former drinkers; people who drank up to seven drinks a week; those who drank between 7 and 14 drinks; 14-21 drinks a week; or 21 or more drinks a week.

Most participants were abstainers (42%) or former drinkers (19%), with 25% reporting up to 7 drinks a week, 8% 7 to 14 drinks a week, and 3% drinking 14-21+ drinks a week.

During the monitoring period, 1,271 men and 1,237 women developed heart failure. The lowest rate of heart failure occurred in those drinking up to seven drinks weekly, and the highest rate was seen among former drinkers.

After taking account of various factors that could have affected the results, men who consumed up to seven drinks a week had a 20% reduced risk of developing heart failure compared to abstainers, while the risk was reduced by 16% in women consuming the same amount.

Former drinkers had the highest risk of developing heart failure – a 19% and 17% increased risk among men and women respectively, compared to abstainers.

Among both men and women drinking the most (14 or more drinks a week), the risk of heart failure was not significantly different compared to the risk for abstainers.

Drinking excessive amounts of alcohol over a long period of time is known to increase the risk of cardiomyopathy. However, the number of very heavy drinkers in the study was small, which could have limited its power to detect such an association.

However, when the researchers looked at death from any cause, there was an increased risk of death of 47% for men and 89% of women who reported consuming 21 or more drinks a week at the start of the study.

“These findings suggest that drinking alcohol in moderation does not contribute to an increased risk of heart failure and may even be protective,” Professor Solomon said. “No level of alcohol intake was associated with a higher risk of heart failure. However, heavy alcohol use is certainly a risk factor for deaths from any cause,” he added.

The higher risk of heart failure and of death from any cause among former drinkers could be related to the reasons why they had stopped drinking in the first place, for instance because they had already developed health problems that might have made them more likely to go on to develop heart failure,” he explained.

The protective effect of moderate drinking were more marginal in women than in men which the authors think could be due to the fact that women metabolise alcohol differently from men and it can affect them differently.

David Leon, Professor of Epidemiology, at the London School of Hygiene & Tropical Medicine, commented: “The authors point out that as the amount people drink goes up so does their overall risk of death. So while this study may be of interest to scientists studying how alcohol affects the heart, overall it is consistent with the emerging consensus that any level of drinking carries risks, and that the more you drink the higher the probability of dying prematurely from something.”

* Alexandra Gonçalves, et al. Alcohol consumption and risk of heart failure: the Atherosclerosis Risk in Communities Study. European Heart Journal 20 January 2015. doi:10.1093/eurheartj/ehu514

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