Department of Family Medicine, College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Int J Environ Res Public Health. 2022 Dec 5;19(23):16265. doi: 10.3390/ijerph192316265.
Background: The association between alcohol intake and newly developed heart failure remains unclear. We aimed to measure the change in alcohol intake between two timepoints to evaluate the association of alcohol consumption with incident heart failure using a population-based study in Korea. Methods: Using the Korean National Health Insurance database, participants who underwent two subsequent national health examinations in 2009 and 2011 were included. Participants were classified into four groups according to total alcohol intake (none: 0 g alcohol/day; light: <15 g alcohol/day; moderate: 15−30 g alcohol/day; and heavy: ≥30 g alcohol/day), and changes in alcohol consumption between the two health exams were grouped into the following five categories: abstainers, sustainers (those who maintained their first examination drinking level), increasers, reducers, and quitters. After adjustment for age, sex, smoking status, regular exercise, socioeconomic information, and comorbidities, the Charlson Comorbidity Index, systolic blood pressure, and laboratory results, a Cox proportional hazards model was used to find the risk of newly diagnosed heart failure (according to ICD-10 code I50 from claims for the first hospitalization) as the primary endpoint. A subgroup analysis among those with a third examination was conducted to reflect further changes in alcohol consumption. Results: Among 3,842,850 subjects, 106,611 (3.0%) were diagnosed with heart failure during the mean follow-up period of 6.3 years. Increasers to a light level of drinking had a lower HF risk compared with abstainers (aHR = 0.91, 95% CI: 0.89−0.94). Those who increased their alcohol intake to a heavy level had a higher HF risk (from light to heavy (aHR = 1.19, 95% CI: 1.12−1.26) and from a moderate to heavy level (aHR = 1.13, 95% CI: 1.07−1.19). Reducing alcohol from a heavy to moderate level was associated with lower HF risk (aHR = 0.90, 95% CI: 0.86−0.95). Conclusion: This study found that light and moderate sustainers had lower incident heart failure risk compared with abstainers. Increased alcohol consumption from light to moderate to heavy was associated with a higher incident heart failure risk.
饮酒与新发生心力衰竭之间的关系尚不清楚。我们旨在测量两个时间点之间饮酒量的变化，以使用韩国的一项基于人群的研究评估饮酒与心力衰竭发生率之间的关系。
利用韩国国家健康保险数据库，纳入了在 2009 年和 2011 年两次后续国家健康检查中接受检查的参与者。根据总饮酒量（无：每天 0 克酒精；轻：<15 克酒精/天；中：15-30 克酒精/天；重：≥30 克酒精/天），将参与者分为四组，并将两次健康检查之间的饮酒量变化分为以下五类：戒酒者、持续饮酒者（保持第一次检查时的饮酒水平）、增量饮酒者、减量饮酒者和戒酒者。调整年龄、性别、吸烟状况、定期运动、社会经济信息和合并症后，使用 Cox 比例风险模型作为主要终点，找出新诊断为心力衰竭（根据首次住院的 ICD-10 代码 I50 进行索赔）的风险。对进行了第三次检查的亚组进行了分析，以进一步反映饮酒量的变化。
在 3842850 名受试者中，106611 名（3.0%）在平均 6.3 年的随访期间被诊断为心力衰竭。与戒酒者相比，增量至轻度饮酒水平的人心力衰竭风险较低（aHR=0.91，95%CI：0.89-0.94）。那些增加饮酒量至重度的人心力衰竭风险较高（从轻度到重度（aHR=1.19，95%CI：1.12-1.26）和从中度到重度（aHR=1.13，95%CI：1.07-1.19）。从重度减少到中度饮酒与心力衰竭风险降低相关（aHR=0.90，95%CI：0.86-0.95）。
本研究发现，与戒酒者相比，轻中度持续饮酒者发生心力衰竭的风险较低。从轻度到中度到重度增加饮酒量与更高的心力衰竭发生率相关。
