Combined Associations of Alcohol Consumption Frequency and Healthy Lifestyle With Risk of Sudden Cardiac Arrest: A...

Frequent alcohol consumption is a cardiovascular risk factor, but its association with sudden cardiac arrest (SCA) across lifestyle profiles remains unclear. We examined the combined associations of drinking frequency and Healthy Lifestyle Score (HLS) with SCA.

This multicenter case-control study, using CAPTURES (Cardiac Arrest Pursuit Trial With Unique Registration and Epidemiologic Surveillance) registry (2017-2023), included 961 SCA cases and 1891 controls who were current drinkers; community controls were frequency-matched by age, sex, and residential area. Alcohol frequency was categorized as low, moderate, or high. HLS was derived from 7 components: smoking; physical activity; sleep; and red meat, fish, fruit, and vegetable intake. Multivariable logistic regression estimated adjusted odds ratios; interactions were assessed on multiplicative and additive scales. Potential impact fractions were estimated under counterfactual shifts in alcohol frequency or HLS.

High-frequency drinking and lower HLS were associated with higher SCA risk (high versus low frequency: adjusted odds ratio, 2.66; HLS 0-2 versus 5-7: adjusted odds ratio, 10.02). Combined analyses showed marked risk concentration: high-frequency drinking with HLS 0-2 yielded an adjusted odds ratio of 29.84 compared with low-frequency drinking with HLS 5-7. Interaction between high-frequency drinking and physical inactivity was additive. Potential impact fractions were 16.1% for an alcohol frequency shift alone, 52.5% for HLS improvement alone, and 58.7% for the combined scenario.

Among current drinkers, frequent alcohol consumption and unfavorable lifestyle profiles were associated with substantially higher SCA risk, with risk concentrated in clustered unhealthy behaviors. These findings may inform multidomain lifestyle strategies for SCA prevention.

URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03700203.