Clinical Investigation
Heart Failure
Association between alcohol consumption and systolic ventricular function: A population-based study

https://doi.org/10.1016/j.ahj.2014.02.014Get rights and content

Background

Although moderate alcohol consumption is associated with decreased clinical heart failure, there are no population-based studies evaluating the relationship between alcohol consumption and left ventricular (LV) systolic function. We sought to evaluate the relationship between alcohol consumption and LV systolic function in the community.

Methods

In a population-based random sample of 2,042 adults, age ≥45 years, we assessed alcohol consumption by a self-administered questionnaire. Responders were categorized by alcohol consumption level: abstainer, former drinker, light drinker (<1 drink a day), moderate drinker (1-2 drinks a day), and heavy drinker (>2 drinks a day). Systolic function was assessed by echocardiography.

Results

We identified 38 cases of systolic dysfunction in 182 abstainers, 309 former drinkers, 1,028 light drinkers, 251 moderate drinkers, and 146 heavy drinkers. A U-shaped relationship was observed between alcohol consumption and moderate systolic dysfunction (LV ejection fraction [LVEF] ≤40%), with the lowest prevalence in light drinkers (0.9%) compared to the highest prevalence in heavy drinkers (5.5%) (odds ratio 0.14, 95% CI 0.04-0.43). This association persisted across different strata of risk factors of systolic dysfunction as well as in multivariate analysis. No significant association between alcohol consumption and systolic function was seen in subjects with LVEF >50% or ≤50%.

Conclusions

There is a U-shaped relationship between alcohol consumption volume and LVEF, with the lowest risk of moderate LV dysfunction (LVEF ≤40%) observed in light drinkers (<1 drink a day). These findings are parallel to the relationship between alcohol consumption and cardiovascular disease prevalence.

Section snippets

Methods

The Olmsted County Heart Function Study was approved by the Mayo Foundation and Olmsted Medical Center Institutional Review boards, and written informed consent was obtained from the subjects. The present study was carried out with funding from US Public Health Services, National Institutes of Health, grant HL-RO1-555902. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper, and its final contents.

Characteristics of study participants

Letters of invitations were sent to 4,203 individuals. Of the 2,042 individuals (48.6%) who participated, 1,916 (941 men and 975 women) had valid data and were included in the present analysis. The majority of participants were light drinkers (n = 1,028, 53.7%), with smaller proportions of abstainers (n = 182, 9.5%), former drinkers (n = 309, 16.1%), moderate drinkers (n = 251, 13.1%), and heavy drinkers (n = 146, 7.6%). Table I shows the baseline characteristics of participants categorized by

Principal findings

This population-based study demonstrated a U-shaped relationship between alcohol consumption and LV systolic function. In the Olmsted County Heart Study, the prevalence of moderate LV systolic dysfunction was the lowest in light drinkers (Table III, row 4; Figure 1), with the prevalence increasing with increasing or decreasing consumption of alcohol, indicating a U-shaped relationship. This relationship remained statistically significant for moderate systolic dysfunction even after adjustment

Conclusion

In a community setting, light alcohol consumption (<1 drink a day) was associated with a reduced prevalence of moderate systolic dysfunction (LVEF ≤40%).

Disclosures

Conflict of interests: The present study was carried out with funding from US Public Health Services, National Institutes of Health, grant HL-RO1-555902.

The authors have no competing interests to disclose.

Acknowledgements

The authors gratefully acknowledge Joe Grundle and Katie Klein for editorial preparation of the manuscript, Brian Miller and Brian Schurrer for their help in preparing figures, and Chi Cho for his help in creating the forest plot.

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    Financial support: US Public Health Services, National Institutes of Health, HL-RO1-555902.

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