Sixty hypertensives (30 with and 30 without heart failure, matched for
age and sex) were studied and their alcohol consumption and its possi
ble role in heart failure were assessed. The majority in each group be
longed to the low socioeconomic class. On presentation, the mean systo
lic blood pressures were 176.7 +/- 29.7 and 198.8 +/- 29.8 mmHg and di
astolic blood pressures 118 +/- 15 and 118.5 +/- 13.6 mmHg, respective
ly. In those known to be hypertensive before presentation to our unit,
hypertension was first detected 4.88 +/- 3.8 and 4.40 +/- 3.3 years e
arlier in the heart failure and non-heart failure groups, respectively
. Drug compliance was similarly poor in the two groups. Of all 12 drin
kers in heart failure, 75% drank heavily, while only 18.2% (two of 11)
of the non-heart failure drinkers drank heavily. Nine (30%) and two (
6.7%) of the heart failure and the non-heart failure groups, respectiv
ely, took greater than or equal to 80 g of alcohol daily for at least
3 years (P < 0.02). Significantly more of the heart failure group were
thiamine deficient, although the deficiency could not be directly att
ributed to alcohol. The odds ratio for heavy and moderate alcohol cons
umption was 5.9 and 0.9, respectively. Thus it is suggested that heavy
alcohol consumption appears to be a major contributory factor to hear
t failure in these patients.