Qin Hailun, van Essen Bart J, Ter Maaten Jozine M, Voors Adriaan A
Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur J Heart Fail. 2025 Jan 20. doi: 10.1002/ejhf.3587.
Regular heavy alcohol consumption may lead to the development of alcohol-related cardiomyopathy and symptomatic heart failure (HF) later in life. However, the dose-response relationship between alcohol consumption and risk for incident HF, and whether these associations vary by sex and type of alcoholic beverage remains unclear.
A total of 407 014 participants (52% women, age 56 years) from the UK Biobank who completed alcohol-related questionnaires and without a history of HF at baseline were included in the study. Competing-risk model and cubic spline regression analyses were used to calculate hazard ratios of the association between alcohol consumption and incident HF in men and women. The associations were adjusted for an extensive set of potential confounders. During a median follow-up of 12 years, 11 735 (34% women) cases of incident HF were identified. Total alcohol consumption was higher in men than in women (median consumption: 16 vs. 8 drinks/week, p < 0.001). A J-shaped association was observed between total alcohol consumption and incident HF in both men and women. Drinking alcohol <28 units/week was associated with a lower risk for developing HF, with a ~20% maximum risk reduction at 14 units/week in men and 7 units/week in women, independent of common confounders. Similar trends were observed in wine consumption. However, the risk of incident HF increases with beer consumption, particularly in women (p for sex interaction = 0.002). Consuming 7-14 units/week of beer was associated with a 29% increased risk of incident HF in women.
Alcohol consumption was higher among men compared with women. Although low to moderate total alcohol consumption appears to be associated with a reduced risk of developed HF, beer drinkers, particularly women, were at higher risk of developed HF.
长期大量饮酒可能导致酒精性心肌病的发生，并在晚年引发有症状的心力衰竭（HF）。然而，酒精摄入量与新发HF风险之间的剂量反应关系，以及这些关联是否因性别和酒精饮料类型而异，仍不明确。
本研究纳入了英国生物银行的407014名参与者（52%为女性，年龄56岁），他们完成了与酒精相关的问卷调查，且基线时无HF病史。采用竞争风险模型和三次样条回归分析来计算男性和女性酒精摄入量与新发HF之间关联的风险比。对一系列潜在混杂因素进行了校正。在中位随访12年期间，共识别出11735例（34%为女性）新发HF病例。男性的总酒精摄入量高于女性（中位摄入量：每周16杯对8杯，p<0.001）。在男性和女性中，总酒精摄入量与新发HF之间均观察到J形关联。每周饮酒<28单位与发生HF的风险较低相关，男性每周14单位、女性每周7单位时风险降低最大约20%，独立于常见混杂因素。葡萄酒消费也观察到类似趋势。然而，HF的发病风险随啤酒消费增加，尤其是在女性中（性别交互作用p=0.002）。女性每周饮用7-14单位啤酒与新发HF风险增加29%相关。
男性的酒精摄入量高于女性。虽然低至中度的总酒精摄入量似乎与发生HF的风险降低相关，但饮用啤酒者，尤其是女性，发生HF的风险更高。
