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Alcohol Consumption and Risk for Congestive Heart Failure in the Framingham Heart Study

Craig R. Walsh, MD; Martin G. Larson, ScD; Jane C. Evans, DSc, MPH; Luc Djousse, MD, MPH; R. Curtis Ellison, MD; Ramachandran S. Vasan, MD; and Daniel Levy, MD
[+] Article and Author Information

From the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, Massachusetts; Massachusetts General Hospital, Boston University School of Medicine, Beth Israel-Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts.


Grant Support: By contract N01-HC-38038 from the National Heart, Lung, and Blood Institute and grant AR/AG 41398 from the National Institutes of Health. Dr. Vasan was supported in part by a research career award 1K24 HL04334 from the National Heart, Lung, and Blood Institute.

Requests for Single Reprints: Daniel Levy, MD, Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.

Current Author Addresses: Drs. Walsh, Larson, Evans, Vasan, and Levy: Framingham Heart Study, 5 Thurber Street, Framingham, MA 01702.

Drs. Djousse and Ellison: Preventive Medicine, Room B-612, Boston University School of Medicine, 715 Albany Street, Boston, MA 02118.

Author Contributions: Conception and design: C.R. Walsh, M.G. Larson, J.C. Evans, D. Levy.

Analysis and interpretation of the data: C.R. Walsh, M.G. Larson, J.C. Evans, R.C. Ellison, R.S. Vasan, D. Levy.

Drafting of the article: C.R. Walsh, R.C. Ellison, R.S. Vasan, D. Levy.

Critical revision of the article for important intellectual content: C.R. Walsh, M.G. Larson, L. Djousse, R.C. Ellison, R.S. Vasan, D. Levy.

Final approval of the article: C.R. Walsh, L. Djousse, R.C. Ellison, R.S. Vasan, D. Levy.

Statistical expertise: M.G. Larson.

Collection and assembly of data: L. Djousse.


Ann Intern Med. 2002;136(3):181-191. doi:10.7326/0003-4819-136-3-200202050-00005
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Regular, heavy consumption of alcohol is associated with subclinical impairment of left ventricular function (13) and occasionally results in overt cardiomyopathy (4). This may be a consequence of direct toxic effects of alcohol or its metabolites (5); coexisting malnutrition (6); associated hypertension (78); increased ventricular mass (9) or, rarely, toxic additives to alcoholic beverages (10). Conversely, moderate alcohol consumption appears to be protective against coronary heart disease (1114). Myocardial infarction is an important risk factor for congestive heart failure (1518). By preventing coronary heart disease, moderate alcohol consumption may indirectly protect against congestive heart failure secondary to myocardial infarction. Thus, the relation of alcohol consumption to the risk for congestive heart failure is probably complex, reflecting the interplay of its coronary protective effects and its myocardial toxic effects.

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Summary for Patients

Alcohol and Risk for Heart Failure

The summary below is from the full report titled “Alcohol Consumption and Risk for Congestive Heart Failure in the Framingham Heart Study.” It is in the 5 February 2002 issue of Annals of Internal Medicine (volume 136, pages 181-191). The authors are CR Walsh, MG Larson, JC Evans, L Djousse, RC Ellison, RS Vasan, and D Levy.

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