Moderate alcohol consumption and risk of heart failure among older persons

Context Heavy consumption of alcohol can lead to heart failure, but the rel ationship between moderate alcohol consumption and risk of heart failure is largely unknown. Objective To determine whether moderate alcohol consumption predicts heart failure risk among older persons, independent of the association of moderat e alcohol consumption with lower risk of myocardial infarction (MI). Design Prospective cohort study conducted from 1982 through 1996, with a ma ximum follow-up of 14 years. Setting and Participants Population-based sample of 2235 noninstitutionaliz ed elderly persons (mean age, 73.7 years; 41.2% male; 21.3% nonwhite) resid ing in New Haven, Conn, who were free of heart failure at baseline. Persons who reported alcohol consumption of more than 70 oz in the month prior to baseline were excluded. Main Outcome Measure Time to first fatal or nonfatal heart failure event, a ccording to the amount of alcohol consumed in the month prior to baseline. Results Increasing alcohol consumption in the moderate range was associated with decreasing heart failure rates. For persons consuming no alcohol (50. 0%), 1 to 20 oz (40.2%), and 21 to 70 oz (9.8%) in the month prior to basel ine, crude heart failure rates per 1000 years of follow-up were 16.1, 12.2, and 9.2, respectively. After adjustment for age, sex, race, education, ang ina, history of MI and diabetes, MI during follow-up, hypertension, pulse p ressure, body mass index, and current smoking, the relative risks of heart failure for those consuming no alcohol, 1 to 20 oz, and 21 to 70 oz in the month prior to baseline were 1.00 (referent), 0.79 (95% confidence interval [CI], 0.60-1.02), and 0.53 (95% CI, 0.32-0.88) (P for trend =.02). Conclusions Increasing levels of moderate alcohol consumption are associate d with a decreasing risk of heart failure among older persons. This associa tion is independent of a number of confounding factors and does not appear to be entirely mediated by a reduction in MI risk.