Compared with long-term abstinence from alcohol, moderate alcohol use by older adults with incident heart failure (HF) is associated with a survival benefit, according to research published in JAMA Network Open.
In this prospective cohort study, community-dwelling adults aged 65 years or older with incident HF (N=393) were drawn from a sample of deidentified patients who had participated in the Cardiovascular Health Study between 1989 and 1993. Only patients diagnosed with incident HF during the first 10 years of the Cardiovascular Health Study were included. Alcohol consumption had been determined at baseline. The researchers divided the participants into 4 categories: abstainers (never drinkers), former drinkers, persons consuming 7 or fewer alcoholic drinks per week, and persons consuming more than 7 drinks per week. Former alcohol drinkers were excluded from the statistical analyses of trends. Diagnoses of HF were determined by a physician and with medical treatment for congestive HF or with “imaging evidence of cardiomegaly and pulmonary edema by chest radiography or dilated ventricle and reduced systolic function by echocardiography or contrast ventriculography.”
After adjusting for demographics and comorbidities, moderate alcohol use of 7 or fewer drinks per week “was associated with significantly longer survival following the diagnosis of HF compared with abstinence (survival of an additional 383 days, 95% CI, 17-748 days; P =.04).” The researchers observed a significant inverted U-shaped association between alcohol consumption and survival: multivariable model estimates of mean time from HF diagnosis to death were 2640 days (95% CI, 1967-3313 days) for abstainers from alcohol use (n=168), 3046 days (95% CI, 2372-3719 days) for consumers of 7 or fewer drinks per week (n=112), and 2806 days (95% CI, 1879-3734 days) for consumers of more than 7 drinks per week (n=17).
The robustness of this study was limited by the small number of individuals in the sample who consumed more than 7 drinks per week.
The study researchers concluded that their findings “have potential implications for the 1 million adults aged more than 55 years who are newly diagnosed with HF each year in the United States. In older patients with incident HF who consumed alcohol before their diagnosis, limited alcohol consumption after the diagnosis appears to be safe.”
Multiple authors declare affiliations with the pharmaceutical industry. Please refer to original reference for a full list of authors’ disclosures.
Sadhu JS, Novak E, Mukamal KJ, et al. Association of alcohol consumption after development of heart failure with survival among older adults in the Cardiovascular Health Study [published online December 28, 2018]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2018.6383