Relation of Alcohol Consumption to Risk of Heart Failure in Patients Aged 65 to 84 Years With Hypertension

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Although a high level of alcohol consumption is associated with cardiomyopathy, the benefit or risk of moderate alcohol consumption on incident heart failure (HF) is unknown. This study examined the association between alcohol consumption and risk for HF in older adults with hypertension. The study analyzed data from a cohort of 6,083 participants aged 65 to 84 years at baseline (1995 to 2001) followed for a median of 10.8 years during and after the Second Australian National Blood Pressure Study. Frequency and amount of alcohol consumption were self-reported at baseline and during the clinical trial. The percentages of current drinkers, former drinkers, and never-drinkers at baseline were 4,400 (72%), 394 (6%), and 1,289 (21%), respectively. Incident HF was diagnosed in 183 men and 136 women. After adjustment for multiple confounders, alcohol consumption was not significantly associated with HF. Compared with never-drinkers, the adjusted hazard ratios (95% confidence interval) for those who consume 1 to 7, 8 to 14, and >14 drinks/week at baseline were 0.87 (0.59 to 1.30), 0.96 (0.57 to 1.60), and 0.71 (0.25 to 2.02), respectively in women, and 0.81 (0.47 to 1.38), 0.77 (0.43 to 1.38), and 1.04 (0.59 to 1.84), respectively in men. The findings of lack of an association between alcohol consumption and risk of HF persisted in the analyses comparing the risk of HF across each level of drinking at baseline or at follow-up with never-drinkers. In the present study, there was no evidence for benefit or risk of alcohol consumption, reported at baseline or at follow-up, in relation to incident HF in both men and women.

Section snippets

Methods

The present study analyzed data from the Second Australian National Blood Pressure study (ANBP2) and data from the ANBP2 post-trial follow-up. Details of the study design, and main findings from the ANBP2 were previously reported.23, 24 Briefly, the ANBP2 trial was a prospective, randomized, open label study with blinded assessment of end points conducted in 1594 Australian general practices from March 1995 to September 2001.23, 24 The study compared the difference in major adverse

Results

At baseline, data regarding alcohol consumption were available for 6,083 participants. Of these, 4,400 (72%) were current drinkers, 394 (7%) were former drinkers, and the remainder 1,289 (21%) were never-drinkers. At baseline, with respect to the current drinkers, 40%, 20%, and 13% of the study participants consumed 1 to 7, 8 to 14, and >14 drinks/week, respectively. For men, the level of alcohol consumption increased as mean age decreased, but alcohol consumption did not vary by age in women.

Discussion

In this long-term follow-up of older adults with hypertension, there was no evidence for benefit or risk of alcohol consumption, reported at baseline or at follow-up, in relation to HF, in either men or women. The findings of lack of an association between alcohol consumption and risk of HF persisted the analysis comparing the risk of HF across each level of current drinking at baseline or at follow-up with never-drinkers.

Alcohol consumption was common in the study population, but only 6% were

Acknowledgments

We are indebted to the participants, study staff, data management centers, and ANBP2 Management Committee. The Management Committee consists of the following members: L.M.H. Wing (Chair), C.M. Reid, L.J. Beilin, M.A. Brown, G.L.R. Jennings, C.I. Johnston, J.J. McNeil, J.E. Marley, T.O. Morgan, P. Ryan, J. Shaw (deceased), M.J. West, and G. MacDonald.

Disclosures

The authors have no conflicts of interest to disclose.

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  • Funding: This work was supported by a National Health and Medical Research Council of Australia (NHMRC) Program Grant (1092642) awarded to CMR. CMR is supported by a Research Fellowship from the NHMRC. ANBP2 was supported by the Australian Commonwealth Department of Health and Aging and the National Health and Medical Research Council of Australia (grant 546272); and Merck Sharp & Dohme (Australia) Pty. Ltd. The long-term ANBP2 cohort follow-up study was supported by an NHMRC program grant (546272). The funding bodies had no role in the design and conduct of the study, and interpretation of the data, or the preparation, review, or approval of the manuscript.

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