Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study

Background: Although excessive alcohol consumption can promote cardiomyopathy, little is known about the association between alcohol consumption and risk for congestive heart failure in the community. Objective: To determine the relation between alcohol consumption and risk for congestive heart failure in the community. Design: Community-based, prospective observational study. Setting: Framingham, Massachusetts. Participants: Participants in the Framingham Heart Study who were free of congestive heart failure and coronary heart disease. Measurements: Self-reported alcohol consumption; sex-specific rates of congestive heart failure per 1000 person-years of follow-up by level of alcohol consumption. Results: In men, 99 cases of congestive heart failure occurred during 26 035 person-years of follow-up. In women, 120 cases of congestive heart failure occurred during 35 563 person-years of follow-up. After adjustment for multiple confounders, risk for congestive heart failure was lower among men at all levels of alcohol consumption compared with men who consumed less than 1 drink/wk. The hazard ratio for congestive heart failure was lowest among men who consumed 8 to 14 drinks/wk (0.41 [95% CI, 0.21 to 0.81]) compared with those who consumed less than 1 drink/wk. In women, the age-adjusted hazard ratio for congestive heart failure was lowest among those who consumed 3 to 7 drinks/wk (0.49 [CI, 0.25 to 0.96]) compared with those who consumed less than 1 drink/wk. However, after adjustment for multiple predictors of congestive heart failure, this association was no longer statistically significant. Conclusions: In the community, alcohol consumption is not associated with increased risk for congestive heart failure, even among heavy drinkers (greater than or equal to15 drinks/wk in men and greater than or equal to8 drinks/wk in women). To the contrary, when consumed in moderation, alcohol appears to protect against congestive heart failure.