Alcohol consumption and risk of heart failure: A dose-response meta-analysis of prospective studies
Aims The aim of this study was to conduct a meta-analysis of prospective studies assessing the relationship between alcohol consumption and risk of heart failure (HF). Methods and results We searched the PubMed database from inception to September 2014 and reviewed the reference list of relevant articles to identify prospective studies assessing the association between alcohol consumption and risk of HF. Study-specific relative risk (RR) estimates were combined using a random-effects meta-analysis. The meta-analysis included eight prospective studies, with a total of 202 378 participants and 6211 cases of HF. The pooled adjusted RRs of HF were 0.85 [95% confidence interval (CI) 0.78-0.93] for light to moderate alcohol consumption (<14 drinks/week) and 0.90 (95% CI 0.72-1.13) for high alcohol consumption (≥14 drinks/week) compared with non-drinkers. In a dose-response meta-analysis, we observed a non-linear relationship between alcohol consumption and risk of HF (P for non-linearity=0.001). Compared with non-drinkers, the RRs (95% CI) across levels of alcohol consumption were 0.90 (0.84-0.96) for 3 drinks/week, 0.83 (0.73-0.95) for 7 drinks/week, 0.84 (0.72-0.98) for 10 drinks/week, 0.90 (0.73-1.10) for 14 drinks/week, and 1.07 (0.77-1.48) for 21 drinks/week. Conclusion Alcohol consumption in moderation is associated with a reduced risk of HF.