Even 'safe' alcohol consumption linked with heart failure

Levels of alcohol consumption currently considered safe by some countries are linked with development of heart failure. That’s according to a new study from Dr Bethany Wong of St. Vincent’s University Hospital, Dublin, presented at the European Society of Cardiology’s Heart Failure 2022 congress.

While it is well recognised that long-term heavy alcohol use in European populations can cause a type of heart failure called alcoholic cardiomyopathy, evidence from Asian populations suggests that lower amounts may also be detrimental. Dr Wong said, “As there are genetic and environmental differences between Asian and European populations, this study investigated if there was a similar relationship between alcohol and cardiac changes in Europeans at risk of heart failure or with pre-heart failure.”

The study was a secondary analysis of the STOP-HF trial, which included 744 adults over 40 years of age either at risk of developing heart failure due to risk factors (eg, high blood pressure, diabetes, obesity) or with pre-heart failure (risk factors and heart abnormalities but no symptoms). It excluded former drinkers and heart failure patients with symptoms (eg, shortness of breath, tiredness, reduced ability to exercise, swollen ankles).

Using the Irish definition of one standard drink, or 10 g of alcohol, participants were categorised according to their weekly alcohol intake: none; low (fewer than seven units); moderate (7–14 units); and high (above 14 units). The association between alcohol use and heart health was analysed over a median of 5.4 years.

In the pre-heart failure group, compared with no alcohol use, moderate or high intake was associated with a 4.5-fold increased risk of worsening heart health, defined as deterioration in the squeezing or relaxation functions of the heart or progression to symptomatic heart failure. The relationship was also observed when moderate and high levels were analysed separately. In the at-risk group, there was no association between moderate or high alcohol use with progression to pre-heart failure or to symptomatic heart failure. No protective associations were found for low alcohol intake.

“Our study suggests that drinking more than 70 g of alcohol per week is associated with worsening pre-heart failure or progression to symptomatic heart failure in Europeans,” Wong said. “We did not observe any benefits of low alcohol usage.

“Our results indicate that countries should advocate lower limits of safe alcohol intake in pre-heart failure patients. In Ireland, for example, those at risk of heart failure or with pre-heart failure are advised to restrict weekly alcohol intake to 11 units for women and 17 units for men. This limit for men is more than twice the amount we found to be safe. More research is needed in Caucasian populations to align results and reduce the mixed messages that clinicians, patients and the public are currently getting.

“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed. To minimise the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three and a half 500 mL cans of 4.5% beer.”

Image credit: ©stock.adobe.com/au/Mark

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