Alcohol abuse may increase risk of heart conditions as much as other risk factors
Researchers analyzed data from a Healthcare Cost and Utilization Project database in California to determine the association between a diagnosis of alcohol abuse and incident atrial fibrillation, myocardial infarction, and congestive heart failure.
Alcohol abuse may increase the risk of atrial fibrillation, heart attack, and congestive heart failure as much as other well-established risk factors such as high blood pressure, diabetes, smoking, and obesity, a study concluded.
Researchers analyzed data from a Healthcare Cost and Utilization Project database of all California residents ages 21 and older who received ambulatory surgery, emergency care, or inpatient medical care in California between 2005 and 2009 to determine the association between a diagnosis of alcohol abuse and incident atrial fibrillation, myocardial infarction, and congestive heart failure. Among the 14.7 million patients in the database, 268,084 patients (1.8% of patients, with 6.3 events/1,000 person-years) were coded with an alcohol abuse diagnosis. Study results were published online by the Journal of the American College of Cardiology.
After multivariable adjustment, alcohol abuse was associated with an increased risk for all three conditions: incident atrial fibrillation (hazard ratio [HR], 2.14; 95% CI, 2.08 to 2.19; P<0.0001), myocardial infarction (HR, 1.45; 95% CI, 1.40 to 1.51; P< 0.0001), and congestive heart failure (HR, 2.34; 95% CI, 2.29 to 2.39; P<0.0001). An interaction analyses showed that patients with alcohol abuse but without conventional risk factors for cardiovascular disease had a disproportionately enhanced risk of each outcome that was similar in magnitude to other well-recognized modifiable risk factors such as diabetes, high blood pressure, and obesity, the authors noted.
On the basis of these data, the researchers estimated that eradicating alcohol abuse would result in over 73,000 fewer atrial fibrillation cases, 34,000 fewer heart attacks, and 91,000 fewer patients with congestive heart failure in the United States alone.
An editorial noted that previous studies finding a protective benefit of light-to-moderate alcohol consumption for heart attack and congestive heart failure were cohort studies, which include defined populations. Such studies tend to recruit stable, cooperative, and health-conscious participants who are more likely to be oriented toward a heathier lifestyle, it stated.
“Alcohol is a potentially addictive and dangerous drug, both for the cardiovascular system and multiple other organ systems,” the editorial concluded. “The recent infatuation with the potential benefits of light-to-moderate drinking for [cardiovascular disease] protection appears to be based on observational and subtly confounded data, rather than on [randomized controlled trial] evidence, and perhaps on more than a little wishful thinking.”