Alcohol Consumption and Risk for Congestive Heart Failure in the Framingham Heart Study

  1. Craig R. Walsh, MD;
  2. Martin G. Larson, ScD;
  3. Jane C. Evans, DSc, MPH;
  4. Luc Djousse, MD, MPH;
  5. R. Curtis Ellison, MD;
  6. Ramachandran S. Vasan, MD; and
  7. Daniel Levy, MD
  1. 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.

    Article and Author Information

    • 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.

    • Requests for Single Reprints: Daniel Levy, MD, Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.

    • Current Author Addresses: Drs. Walsh, Larson, Evans, Vasan, and Levy: Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.

    • Drs. Djousse and Ellison: Preventive Medicine, Room B-612, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118.

    • Author Contributions: Conception and design: C.R. Walsh, M.G. Larson, J.C. Evans, D. Levy.

    • Analysis and interpretation of the data: C.R. Walsh, M.G. Larson, J.C. Evans, R.C. Ellison, R.S. Vasan, D. Levy.

    • Drafting of the article: C.R. Walsh, R.C. Ellison, R.S. Vasan, D. Levy.

    • 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.

    • Final approval of the article: C.R. Walsh, L. Djousse, R.C. Ellison, R.S. Vasan, D. Levy.

    • Statistical expertise: M.G. Larson.

    • Collection and assembly of data: L. Djousse.

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    1. Ann Intern Med February 5, 2002 vol. 136 no. 3 181-191
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