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Moderate Alcohol Use Not a Risk Factor for CHF

Alcohol and cardiac disease may not be a bad mix.

Although moderate drinking may prevent coronary artery disease and myocardial infarction, heavy drinking can cause alcoholic cardiomyopathy. Results from 2 studies help to clarify the relation between moderate drinking and congestive heart failure.

Framingham Heart Study investigators studied a prospective community-based cohort of 6289 adults: 219 developed CHF during a maximum follow-up of 5 years. In analyses that adjusted for CAD risk factors, men who consumed up to 14 alcoholic drinks weekly had significantly lower risk for CHF than did nondrinkers. Risk was also lower among women who consumed 3 to 7 drinks per week (P=0.05).

Another group of researchers evaluated 55 alcoholic Spanish men who had symptomatic cardiomyopathy; all were urged to abstain from drinking. The 17 patients who abstained and the 15 who reduced their alcohol intake to 20 to 60 grams of ethanol daily (4 standard drinks) had statistically significant increases in left ventricular ejection fraction (mean increase, 13 percentage points) at 1 year. Ejection fraction decreased in most patients who consumed more than 80 grams of ethanol daily.

Comment: These results, as well as those from many other studies, suggest that moderate drinking is good for the heart, diabetes, and even cognitive function. However, the many limitations of these observational studies, and the need to consider other health effects of alcohol, restrict how the results can be applied to individual patients. Although patients should not start drinking as therapy for their cardiomyopathy, it seems safe to conclude that some people with congestive heart failure can drink moderate amounts of alcohol without ill effect.

— Richard Saitz, MD, MPH

Published in Journal Watch General Medicine February 12, 2002

Citation(s):

Walsh CR et al. Alcohol consumption and risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med 2002 Feb 5; 136:181-91.

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• Medline abstract (Free)

Nicolás JM et al. The effect of controlled drinking in alcoholic cardiomyopathy. Ann Intern Med 2002 Feb 5; 136:192-200.

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• Medline abstract (Free)