A Link Between Moderate Drinking, Congestive Heart Failure, and Myocardial Infarction?

Because it protects against myocardial infarction (MI), moderate drinking may also lower the risk of congestive heart failure (CHF). Researchers used data from a prospective study on cardiovascular health to assess this possibility. They examined alcohol use and incident CHF and MI in 5595 subjects, aged 65 or older, who had been followed for 7 to 10 years. During follow-up, 1056 events of CHF occurred.

• In analyses adjusted for potential confounders but not MI, the risk of CHF was lower in subjects who drank 1–6 alcoholic drinks per week (hazard ratio [HR] 0.8, P=0.05) and 7–13 drinks per week (HR 0.7, P=0.01) than in subjects who never drank alcohol.
• Hazard ratios remained the same in analyses adjusted for incident myocardial infarction (MI) (P=0.11 for 1– 6 drinks and P=0.04 for 7–13 drinks).
• Former drinkers at baseline had a significantly higher risk of CHF than did subjects who never drank (HR 1.6 in analyses adjusted for MI).

Comments:

Most previous studies on this topic have also shown that moderate drinkers have a lower risk of developing CHF. Further, this study found (as have others) that the protection against CHF in moderate drinkers is not entirely mediated through reduction in MI risk. Although former drinkers at baseline had an increased CHF risk, no information on the drinking patterns of either former or current drinkers was provided—leaving unanswered questions about how to interpret this finding clinically.

R. Curtis Ellison, MD

Reference:

Bryson CL, Mukamal KJ, Mittleman MA, et al. The association of alcohol consumption and incident heart failure: the Cardiovascular Health Study. J Am Coll Cardiol. 2006;48(2):305–311.