According to recent data presented at Heart Failure 2022, a scientific meeting of the European Society of Cardiology, levels of alcohol intake currently deemed acceptable by some nations are linked to the development of heart failure (ESC).
“This study adds to the body of evidence that a more cautious approach to alcohol consumption is needed,” said study author Dr. Bethany Wong of St. Vincent’s University Hospital, Dublin, Ireland. “To minimize the risk of alcohol causing harm to the heart, if you don’t drink, don’t start. If you do drink, limit your weekly consumption to less than one bottle of wine or less than three-and-a-half 500 ml cans of 4.5% beer.”
The European Union is the world's heaviest-drinking area, according to the World Health Organization (WHO).
While it is generally understood that long-term high alcohol intake can lead to alcoholic cardiomyopathy, research from Asian populations shows that lesser levels can be harmful as well. “As there are genetic and environmental differences between Asian and European populations this study investigated if there was a similar relationship between alcohol and cardiac changes in Europeans at risk of heart failure or with pre-heart failure,” Dr. Wong explained. “The mainstay of treatment for this group is management of risk factors such as alcohol, so knowledge about safe levels is crucial.”
This was a follow-up study on the STOP-HF experiment. The participants in the research were 744 individuals over the age of 40 who were either at risk of developing heart failure due to risk factors (e.g., high blood pressure, diabetes, obesity) or had pre-heart failure (risk factors and heart abnormalities but no symptoms). The average age was 66.5 years, and 53 percent of the participants were female. Former drinkers and heart failure patients having symptoms were not included in the research (e.g. shortness of breath, tiredness, reduced ability to exercise, swollen ankles). During baseline and at follow-up, echocardiography was used to assess heart function.
The researchers employed the Irish definition of a standard drink (i.e. a unit), which is 10 grams of alcohol. Participants were divided into four groups based on their weekly alcohol consumption: 1) none; 2) low (less than seven units; up to one 750 mL bottle of 12.5 percent wine or three-and-a-half 500 mL cans of 4.5 percent beer); 3) moderate (7-14 units; up to two bottles of 12.5 percent wine or seven 500 mL cans of 4.5 percent beer); 4) high (more than fourteen units; up to two bottles of 12.5 percent wine or seven 500 mL cans of 4.5 percent beer (above 14 units; more than two bottles of 12.5 percent wine or seven 500 ml cans of 4.5 percent beer).
Over a median of 5.4 years, the researchers studied the link between alcohol use and heart health. For the at-risk and pre-heart failure groups, the results were presented individually. The progression to pre-heart failure or symptomatic heart failure in the at-risk group was defined as deteriorating heart health. Worsening heart health was defined as a decline in the heart's squeezing or relaxation functions or progression to symptomatic heart failure in the pre-heart failure group. Age, gender, obesity, high blood pressure, diabetes, and vascular disease were all taken into account when the analyses were performed.
A total of 201 patients (27%) reported no alcohol consumption, while 356 (48%) indicated low consumption and 187 (25%) reported moderate or high consumption. Those with moderate or high consumption were younger, more likely to be male, and had a greater BMI than those with low intake.
In the pre-heart failure group, moderate or heavy alcohol use was linked to a 4.5-fold greater risk of poor heart health as compared to no alcohol consumption. When moderate and high levels were examined independently, the same association was discovered. There was no link between moderate or high alcohol use and progression to pre-heart failure or symptomatic heart failure in the at-risk group. Low alcohol consumption was shown to have no protective effects.
“Our study suggests that drinking more than 70 g of alcohol per week is associated with worsening pre-heart failure or progression to symptomatic heart failure in Europeans. We did not observe any benefits of low alcohol usage. Our results indicate that countries should advocate lower limits of safe alcohol intake in pre-heart failure patients. In Ireland, for example, those at risk of heart failure or with pre-heart failure are advised to restrict weekly alcohol intake to 11 units for women and 17 units for men. This limit for men is more than twice the amount we found to be safe. More research is needed in Caucasian populations to align results and reduce the mixed messages that clinicians, patients, and the public are currently getting,” Dr. Wong stated.
