Alcohol Consumption and Risk for Congestive Heart Failure in the Framingham Heart Study
- Craig R. Walsh, MD;
- Martin G. Larson, ScD;
- Jane C. Evans, DSc, MPH;
- Luc Djousse, MD, MPH;
- R. Curtis Ellison, MD;
- Ramachandran S. Vasan, MD; and
- Daniel Levy, MD
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, Massachusetts; Massachusetts General Hospital, Boston University School of Medicine, Beth Israel-Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts.
Abstract
Background: Although excessive alcohol consumption can promote cardiomyopathy, little is known about the association between alcohol consumption and risk for congestive heart failure in the community.
Objective: To determine the relation between alcohol consumption and risk for congestive heart failure in the community.
Design: Community-based, prospective observational study.
Setting: Framingham, Massachusetts.
Participants: Participants in the Framingham Heart Study who were free of congestive heart failure and coronary heart disease.
Measurements: Self-reported alcohol consumption; sex-specific rates of congestive heart failure per 1000 person-years of follow-up by level of alcohol consumption.
Results: In men, 99 cases of congestive heart failure occurred during 26 035 person-years of follow-up. In women, 120 cases of congestive heart failure occurred during 35 563 person-years of follow-up. After adjustment for multiple confounders, risk for congestive heart failure was lower among men at all levels of alcohol consumption compared with men who consumed less than 1 drink/wk. The hazard ratio for congestive heart failure was lowest among men who consumed 8 to 14 drinks/wk (0.41 [95% CI, 0.21 to 0.81]) compared with those who consumed less than 1 drink/wk. In women, the age-adjusted hazard ratio for congestive heart failure was lowest among those who consumed 3 to 7 drinks/wk (0.49 [CI, 0.25 to 0.96]) compared with those who consumed less than 1 drink/wk. However, after adjustment for multiple predictors of congestive heart failure, this association was no longer statistically significant.
Conclusions: In the community, alcohol consumption is not associated with increased risk for congestive heart failure, even among heavy drinkers (≥ 15 drinks/wk in men and ≥ 8 drinks/wk in women). To the contrary, when consumed in moderation, alcohol appears to protect against congestive heart failure.
- Heart failure, congestive
- Alcohol drinking
- Myocardial infarction
- Coronary disease
- Cardiomyopathy, alcoholic
Article and Author Information
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Grant Support: By contract N01-HC-38038 from the National Heart, Lung, and Blood Institute and grant AR/AG 41398 from the National Institutes of Health. Dr. Vasan was supported in part by a research career award 1K24 HL04334 from the National Heart, Lung, and Blood Institute.
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Requests for Single Reprints: Daniel Levy, MD, Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.
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Current Author Addresses: Drs. Walsh, Larson, Evans, Vasan, and Levy: Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.
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Drs. Djousse and Ellison: Preventive Medicine, Room B-612, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118.
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Author Contributions: Conception and design: C.R. Walsh, M.G. Larson, J.C. Evans, D. Levy.
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Analysis and interpretation of the data: C.R. Walsh, M.G. Larson, J.C. Evans, R.C. Ellison, R.S. Vasan, D. Levy.
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Drafting of the article: C.R. Walsh, R.C. Ellison, R.S. Vasan, D. Levy.
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Critical revision of the article for important intellectual content: C.R. Walsh, M.G. Larson, L. Djousse, R.C. Ellison, R.S. Vasan, D. Levy.
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Final approval of the article: C.R. Walsh, L. Djousse, R.C. Ellison, R.S. Vasan, D. Levy.
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Statistical expertise: M.G. Larson.
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Collection and assembly of data: L. Djousse.
- Copyright ©2004 by the American College of Physicians
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