Alcohol Consumption and Heart Failure in Hypertensive US Male Physicians

Abstract

While alcohol drinking raises blood pressure and heavy drinking has been associated with alcoholic cardiomyopathy, little is known about the association between light-to-moderate drinking on the risk of heart failure (HF) among hypertensive subjects. Thus, we prospectively examined the association between light-to-moderate drinking and incident HF in 5,153 hypertensive male physicians who were free of stroke, myocardial infarction, or major cancers at baseline. Alcohol consumption was selfreported and classified as <1, 1-4, 5-7, and 8+ drinks/week. HF was ascertained through follow-up questionnaires and validated using Framingham criteria. The average age was 58 years and about 70% of the participants consumed 1-7 drinks per week. A total of 478 incident HF cases occurred in this cohort during the follow up. Compared to subjects consuming < 1 drink per week, hazard ratios (95% confidence interval) for HF were 0.89 (0.70-1.12), 0.72 (0.57-0.91), and 0.38 (0.20-0.72) for alcohol consumption of 1-4, 5-7, and 8+ drinks/week, respectively, after adjustment for age, body mass index, smoking, randomization's group, use of multivitamins, vegetable consumption, breakfast cereal, exercise, and history of atrial fibrillation (p for trend <0.001). Similar results were obtained for HF with and without antecedent myocardial infarction and among subjects without diabetes mellitus. In conclusion, our data suggest that light-to-moderate alcohol consumption is associated with a lower risk of HF among hypertensive male physicians. KeywordsAlcohol drinking; heart failure; epidemiology; risk factor Moderate drinking may lower the risk of heart failure (HF) caused by antecedent coronary artery disease. Recent alcohol consumption was not associated with the subsequent risk for HF among patients who had a myocardial infarction 1,2 . In addition, among post-myocardial infarction patients with left ventricular dysfunction, moderate drinking was not associated with incident HF 1,2 . In contrast, other investigators have reported an inverse relation between lightto-moderate drinking and HF risk in the general population 3-6 . No previous study has examined the association between moderate drinking and incident HF among individuals with hypertension. Since moderate alcohol intake could lower the risk of HF (through its beneficial effects on coronary artery disease and neurohormonal changes that might prevent clinical onset of HF 7-9 ) and increase the risk of HF through hypertensive cardiomyopathy, it is important to understand the net benefit if any, of light-to-moderate drinking (≤ 2 drinks per day for men) among people with hypertension. Thus, we prospectively assessed whether alcohol consumption was associated with a lower risk of incident HF among US male physicians with prevalent hypertension at baseline. In addition, we examined whether alcohol consumption influenced the risk of HF with and without antecedent myocardial infarction in this population. Materials and MethodsWe used data from the Physicians' Health Study (PHS) I,...

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