Objectives: The association between alcohol consumption and risk of heart failure (HF) remains controversial. The objective of this study was to examine the association between alcohol consumption and incident HF in Chinese adults, and to conduct a meta-analysis to summarize prospective data on alcohol and HF.
Methods: The prospective study included 97, 310 Chinese men and women (mean age: 51±12 yr.) from the Kailuan Study who were free of HF in 2006 (baseline) and followed up to Dec. 2015. Baseline alcohol consumption was assessed via a questionnaire, and was grouped as never drinkers, former drinkers, light (women: 0-0.4 drinks/day, men: 0-0.9 drinks/day), moderate (women: 0.5-1 drinks/day, men:1-2 drinks/day) and high (women: >1 drinks/day, men: >2 drinks/day) alcohol intake. Incident HF at follow up was defined as a first HF event, confirmed by review of medical records. Multivariable Cox proportional hazard ratio was used to examine the association between alcohol consumption and time to heart failure, adjusting for potential covariates including age, sex, education, monthly income, occupation, smoking status, physical activity, body mass index, hypertension, diabetes and total cholesterol. A meta-analysis including 13 published prospective studies on alcohol and heart failure, and this current study was conducted using random-effects models.
Results: During an average of 8.8 years follow up, we documented 1597 incident HF cases. Compared with never and past drinkers, the corresponding adjusted hazard ratios (HRs) for light, moderate and high alcohol intake were 0.71 (95%CI: 0.59,0.86), 0.84 (95%CI: 0.62, 1.13), and 0.63 (95%CI: 0.52, 0.76), respectively. In the meta-analysis including 491,374 participants, we observed a significantly lower risk for HF among light-drinkers (pooled HR for light alcohol intake vs non-drinkers was 0.84 (95% CI: 0.80, 0.89)). In contrast, we did not find significant associations between moderate and high alcohol intake and HF risk.
Conclusions: Alcohol intake was associated with a lower risk for HF incidence. Meta-analysis confirmed the lower risk of HF associated with light alcohol intake. However, because of large heterogeneity across studies, particularly for the moderate and high intake categories, results should be interpreted with caution.