Alcohol consumption and incident heart failure in men and women

Regular heavy alcohol consumption may lead to the development of alcohol-related cardiomyopathy and symptomatic heart failure (HF) later in life. However, the dose-response relationship between alcohol consumption and risk for incident HF, and whether these associations vary by sex and type of alcoholic beverage remains unclear.

A total of 407 014 participants (52% women, age 56 years) from the UK Biobank who completed alcohol-related questionnaires and without a history of HF at baseline were included in the study. Competing-risk model and cubic spline regression analyses were used to calculate hazard ratios of the association between alcohol consumption and incident HF in men and women. The associations were adjusted for an extensive set of potential confounders. During a median follow-up of 12 years, 11 735 (34% women) cases of incident HF were identified. Total alcohol consumption was higher in men than in women (median consumption: 16 vs. 8 drinks/week, p < 0.001). A J-shaped association was observed between total alcohol consumption and incident HF in both men and women. Drinking alcohol <28 units/week was associated with a lower risk for developing HF, with a ~20% maximum risk reduction at 14 units/week in men and 7 units/week in women, independent of common confounders. Similar trends were observed in wine consumption. However, the risk of incident HF increases with beer consumption, particularly in women (p for sex interaction = 0.002). Consuming 7-14 units/week of beer was associated with a 29% increased risk of incident HF in women.

Alcohol consumption was higher among men compared with women. Although low to moderate total alcohol consumption appears to be associated with a reduced risk of developed HF, beer drinkers, particularly women, were at higher risk of developed HF.