Alcohol consumption

Even safe levels of alcohol consumption can harm the heart

Levels of alcohol consumption currently considered safe by some countries are linked to the development of heart failure, according to a study presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC).

This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed. To minimize the risk of alcohol causing heart damage, if you’re not drinking, don’t start. If you drink, limit your weekly intake to less than one bottle of wine or less than three and a half 500ml cans of 4.5% beer. »


Dr Bethany Wong, study author, St. Vincent’s University Hospital, Dublin, Ireland

According to the World Health Organization, the European Union is the most alcohol-consuming region in the world. Although it is well recognized that excessive long-term alcohol consumption can cause a type of heart failure called alcoholic cardiomyopathy, evidence from Asian populations suggests that low amounts can also be detrimental. “Because there are genetic and environmental differences between Asian and European populations, this study investigated whether there is a similar relationship between alcohol and heart changes in Europeans at risk for heart failure or pre-heart failure. heart,” Dr. Wong said. “The mainstay of treatment for this group is the management of risk factors such as alcohol, so knowledge of safe levels is crucial.”

This was a secondary analysis of the STOP-HF trial. The study included 744 adults over the age of 40 either at risk of developing heart failure due to risk factors (eg, high blood pressure, diabetes, obesity) or pre-heart failure (risk factors and heart abnormalities but no symptoms). The average age was 66.5 years and 53% were women. The study excluded former drinkers and heart failure patients with symptoms (eg, shortness of breath, fatigue, reduced ability to exercise, swollen ankles). Cardiac function was measured by echocardiography at baseline and at follow-up.

The study used the Irish definition of a standard drink (i.e. one unit), which is 10 grams of alcohol. Participants were categorized according to their weekly alcohol consumption: 1) none; 2) low (less than seven units; up to one 750 ml bottle of 12.5% ​​wine or three and a half 500 ml cans of 4.5% beer); 3) moderate (7-14 units; up to two bottles of 12.5% ​​wine or seven 500ml cans of 4.5% beer); 4) high (more than 14 units; more than two bottles of 12.5% ​​wine or seven 500 ml cans of 4.5% beer).

The researchers analyzed the association between alcohol consumption and heart health over a median of 5.4 years. Results were reported separately for the at-risk and pre-heart failure groups. In the at-risk group, worsening heart health was defined as progression to pre-cardiac heart failure or symptomatic heart failure. For the pre-heart failure group, worsening heart health was defined as deterioration in the compression or relaxation functions of the heart or progression to symptomatic heart failure. Analyzes were adjusted for factors that can affect heart structure, including age, sex, obesity, high blood pressure, diabetes, and vascular disease.

A total of 201 (27%) patients reported no alcohol consumption, while 356 (48%) were light drinkers and 187 (25%) had moderate or heavy consumption. Compared to the low drinking group, those with moderate or high drinking were younger, more likely to be male, and had a higher body mass index.

In the pre-heart failure group, compared to no alcohol consumption, moderate or heavy drinking was associated with a 4.5 times greater risk of worsening heart health. The relationship was also observed when moderate and high levels were analyzed separately. In the risk group, there was no association between moderate or heavy alcohol consumption and progression to pre-cardiac heart failure or to symptomatic heart failure. No protective association was found for low alcohol consumption.

Dr Wong said: “Our study suggests that drinking more than 70g of alcohol per week is associated with worsening of heart failure or progression to symptomatic heart failure in Europeans. We did not observed no benefit from low alcohol consumption. Our results indicate that countries should advocate lower limits of safe alcohol consumption in patients with pre-heart failure. In Ireland, for example, people are advised at risk of heart failure or with heart failure to limit their weekly alcohol intake to 11 units for women and 17 units for men.This limit for men is more than twice the amount we have found safe. Further research is needed in Caucasian populations to align the findings and reduce the mixed messages that clinicians, l Patients and the public are currently receiving.