Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

Wannamethee, S. Goya; Whincup, Peter H.; Lennon, Lucy; Papacosta, Olia; Ag, Shaper

doi:10.1136/openhrt-2015-000266

Cited by 18 publications

(18 citation statements)

References 34 publications

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“…The current findings are based on doctor-diagnosed HF, which may underestimate the true incidence of HF in this study population. However, the determinants of HF in this study population (including obesity, NT-proBNP, social class and heavy drinking) 22 24 36 37 generally accord with prior data and suggest that the HF outcome used was valid. Adjustments were based on measurements at examination, and we had no information on incident AF, which is associated with reduced lung function and HF risk.…”

Section: Strengths and Limitationssupporting

confidence: 81%

Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men—the British Regional Heart Study

Wannamethee

Shaper

Papacosta

et al. 2016

Thorax

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AimsThe association between lung function and cardiac markers and heart failure (HF) has been little studied in the general older population. We have examined the association between lung function and airway obstruction with cardiac markers N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) and risk of incident HF in older men.Methods and resultsProspective study of 3242 men aged 60–79 years without prevalent HF or myocardial infarction followed up for an average period of 13 years, in whom 211 incident HF cases occurred. Incident HF was examined in relation to % predicted FEV1 and FVC. The Global Initiative on Obstructive Lung Diseases spirometry criteria were used to define airway obstruction. Reduced FEV1, but not FVC in the normal range, was significantly associated with increased risk of HF after adjustment for established HF risk factors including inflammation. The adjusted HRs comparing men in the 6–24th percentile with the highest quartile were 1.91 (1.24 to 2.94) and 1.30 (0.86 to 1.96) for FEV1 and FVC, respectively. FEV1 and FVC were inversely associated with NT-proBNP and cTnT, although the association between FEV1 and incident HF remained after adjustment for NT-proBNP and cTnT. Compared with normal subjects (FEV1/FVC ≥0.70 and FVC≥80%), moderate or severe (FEV1/FVC <0.70 and FEV1 <80%) airflow obstruction was independently associated with HF ((adjusted relative risk 1.59 (1.08 to 2.33)). Airflow restriction (FEV1/FVC ≥0.70 and FVC <80%) was not independently associated with HF.ConclusionsReduced FEV1 reflecting airflow obstruction is associated with cardiac dysfunction and increased risk of incident HF in older men.

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Section: Strengths and Limitationssupporting

confidence: 81%

Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men—the British Regional Heart Study

Wannamethee

Shaper

Papacosta

et al. 2016

Thorax

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“…The current findings are based on physician‐diagnosed HF, which has yielded estimates of HF incidence consistent with those of earlier reports . Moreover, the determinants of HF in this study population (including obesity, NT‐proBNP, lung function, and heavy drinking) generally accord with prior data and suggest that the HF outcome used was valid. However, echocardiographic measurements were not routinely performed, and we were not able to differentiate systolic and diastolic HF.…”

Section: Discussionsupporting

confidence: 87%

Serum Conjugated Linoleic Acid and Risk of Incident Heart Failure in Older Men: The British Regional Heart Study

Wannamethee

Jefferis

Lennon

et al. 2018

JAHA

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BackgroundEvidence largely from animal studies suggests that conjugated linoleic acid (CLA) may have cardiovascular health benefits. However, few prospective studies have examined the association between CLA and cardiovascular disease. We have prospectively examined the association between serum CLA and incident coronary heart disease and heart failure (HF) in older men.Methods and ResultsProspective study of 3806 men, aged 60 to 79 years, without prevalent HF followed up for an average of 13 years, during which there were 295 incident HF cases. A high‐throughput serum nuclear magnetic resonance metabolomics platform was used to measure CLA concentration in serum, expressed as a percentage of total fatty acids (CLA%). CLA% was adversely associated with cholesterol and high‐density lipoprotein cholesterol but was inversely associated with C‐reactive protein and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide; a marker of ventricular stress). No association was seen between CLA% and incident coronary heart disease. High CLA% was associated with significantly reduced risk of HF after adjustment for HF risk factors and C‐reactive protein (hazard ratio [95% confidence interval], 0.64 [0.43–0.96]; quartile 4 versus quartile 1). Elevated CLA% was associated with reduced HF risk only in those with higher dairy fat intake, a major dietary source of CLA (test for interaction P=0.03). The reduced risk of HF was partially explained by NT‐proBNP. High dairy fat intake was not associated with incident coronary heart disease but was associated with reduced risk of HF, largely because of the inverse effect of CLA.ConclusionsThe finding that high CLA% is associated with lower risk of incident HF in older men requires confirmation in larger studies.

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“…In contrast, Wannamethee and colleagues (2015) recently examined different levels of alcohol consumption and risk for heart failure in an older population (mean age ~68) and found no evidence that light-to-moderate drinking had a protective effect on incident heart failure in this age group. On the other hand, drinking ≥5 drinks/day (or ≥35 drinks/week) was associated with a significant risk of heart failure.…”

Section: Alcohol and Heart Failurementioning

confidence: 97%

Effects of Alcohol on the Cardiovascular System in Women

Piano

Hill

Hwang

et al. 2020

ARCR

148

153

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Alcohol use has complex effects on cardiovascular (CV) health. The associations between drinking and CV diseases such as hypertension, coronary heart disease, stroke, peripheral arterial disease, and cardiomyopathy have been studied extensively and are outlined in this review. Although many behavioral, genetic, and biologic variants influence the interconnection between alcohol use and CV disease, dose and pattern of alcohol consumption seem to modulate this most. Low-to-moderate alcohol use may mitigate certain mechanisms such as risk and hemostatic factors affecting atherosclerosis and inflammation, pathophysiologic processes integral to most CV disease. But any positive aspects of drinking must be weighed against serious physiological effects, including mitochondrial dysfunction and changes in circulation, inflammatory response, oxidative stress, and programmed cell death, as well as anatomical damage to the CV system, especially the heart itself. Both the negative and positive effects of alcohol use on particular CV conditions are presented here. The review concludes by suggesting several promising avenues for future research related to alcohol use and CV disease. These include using direct biomarkers of alcohol to confirm self-report of alcohol consumption levels; studying potential mediation of various genetic, socioeconomic, and racial and ethnic factors that may affect alcohol use and CV disease; reviewing alcohol–medication interactions in cardiac patients; and examining CV effects of alcohol use in young adults and in older adults.

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Alcohol consumption and risk of incident heart failure in older men: a prospective cohort study

Cited by 18 publications

References 34 publications

Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men—the British Regional Heart Study

Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men—the British Regional Heart Study

Serum Conjugated Linoleic Acid and Risk of Incident Heart Failure in Older Men: The British Regional Heart Study

Effects of Alcohol on the Cardiovascular System in Women

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