ESC: New study finds drinking is more harmful to the heart than previously thought

Alcohol consumption levels currently considered safe in some countries are linked to the development of heart failure, according to new research presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC). "This study adds to the evidence that a more cautious approach to alcohol consumption is needed," said study author Dr. Bethany Wong of St. Vincent's University Hospital in Dublin, Ireland.

"To minimise the risk of heart harm from alcohol, don't start drinking if you don't drink. If you do drink, limit your consumption to less than one bottle per week, or less than three and a half 500ml cans of 4.5% beer."

The European Union is the region with the highest alcohol consumption in the world, according to the World Health Organization (WHO). While it is well established that heavy, long-term drinking can lead to a type of heart failure called alcoholic cardiomyopathy, evidence from Asian populations suggests that lower amounts may also be harmful. "Because there are genetic and environmental differences between Asian and European populations, this study investigated whether a similar relationship exists between alcohol and heart changes at risk for heart failure or in the pre-heart failure phase in Europeans," said Dr. Wong. "Treatment for this population is primarily focused on management of risk factors such as alcohol, so knowledge of safe levels is critical."

This was a secondary analysis of the STOP-HF trial. The study included 744 adults aged 40 years or older who were at risk for heart failure due to risk factors (such as high blood pressure, diabetes, obesity) or who had pre-heart failure (risk factors and heart abnormalities but no symptoms). The mean age of the sample was 66.5 years, and 53% were women. The study excluded people who had ever drunk alcohol and those with symptoms of heart failure (such as shortness of breath, tiredness, decreased exercise ability, and swollen ankles). Heart function was measured with echocardiography at baseline and follow-up.

The study used the Irish definition of a standard drink, or one unit, which is 10 grams of alcohol. Participants were categorized according to their weekly alcohol intake: 1) none; 2) low (less than seven units; up to one 750 ml bottle of 12.5% ​​wine or three and a half cans of 4.5% beer); 3) moderate (7-14 units; up to two bottles of 12.5% ​​wine or seven 500 ml cans of 4.5% beer); and 4) high (more than 14 units; more than two bottles of 12.5% ​​wine or seven 500 ml cans of 4.5% beer).

The researchers analyzed the relationship between alcohol drinking and heart health over a median of 5.4 years. Results were reported separately for high-risk and pre-heart failure groups. In the high-risk group, worsening heart health was defined as progression to pre-heart failure or symptomatic heart failure. For the pre-heart failure group, worsening heart health was defined as worsening of the heart's squeezing or relaxing function or progression to symptomatic heart failure. The analyses were adjusted for factors that could affect heart structure, including age, sex, obesity, hypertension, diabetes, and vascular disease.

A total of 201 (27%) patients reported no alcohol consumption, while 356 (48%) were low users and 187 (25%) had moderate or high intake. Compared with the low intake group, those with moderate or high intake were younger, more likely to be male, and have a higher body mass index.

In the pre-heart failure group, moderate or high intake was associated with a 4.5-fold increased risk of worsening heart health compared with no drinking. This relationship was also observed when moderate and high intake were analyzed separately. In the high-risk group, there was no association between moderate or high drinking and progression to pre-heart failure or symptomatic heart failure. No protective association was found for low alcohol intake.

Dr Wong said: "Our study shows that drinking more than 70g of alcohol per week is associated with worsening of pre-heart failure or progression to symptomatic heart failure in Europeans. We did not observe any benefit from lower alcohol consumption. Our results suggest that countries should advocate for lower limits of safe alcohol intake for people with pre-heart failure. For example, in Ireland, those at risk of heart failure or with pre-heart failure are advised to limit their weekly alcohol intake to 11 units for women and 17 units for men. This limit for men is more than double the amount we found to be safe. More research in Caucasians is needed to tailor the results and reduce mixed messages for clinicians, patients and the public."

From cnBeta.COM