Alcohol consumption and heart failure in hypertensives

Sixty hypertensives (30 with and 30 without heart failure, matched for age and sex) were studied and their alcohol consumption and its possible role in heart failure were assessed. The majority in each group belonged to the low socioeconomic class. On presentation, the mean systolic blood pressures were 176.7 +/- 29.7 and 198.8 +/- 29.8 mmHg and diastolic blood pressures 118 +/- 15 and 118.5 +/- 13.6 mmHg, respectively. In those known to be hypertensive before presentation to our unit, hypertension was first detected 4.88 +/- 3.8 and 4.40 +/- 3.3 years earlier in the heart failure and non-heart failure groups, respectively. Drug compliance was similarly poor in the two groups. Of all 12 drinkers in heart failure, 75% drank heavily, while only 18.2% (two of 11) of the non-heart failure drinkers drank heavily. Nine (30%) and two (6.7%) of the heart failure and the non-heart failure groups, respectively, took greater than or equal to 80 g of alcohol daily for at least 3 years (P < 0.02). Significantly more of the heart failure group were thiamine deficient, although the deficiency could not be directly attributed to alcohol. The odds ratio for heavy and moderate alcohol consumption was 5.9 and 0.9, respectively. Thus it is suggested that heavy alcohol consumption appears to be a major contributory factor to heart failure in these patients.