Alcohol and Systolic Function | Journal Scan

Study Questions:

What is the influence of moderate alcohol use on cardiac structure and function in the elderly?


The study was conducted in 4,466 participants from visit 5 of the ARIC (Atherosclerosis Risk in Communities) study, who underwent echocardiography. Exclusion criteria included those classified as former drinkers and those with significant valvular disease. Participants were classified into four categories based on self-reported alcohol intake: nondrinkers, drinkers of ≤7, ≥7 to 14, and ≥14 drinks per week. Alcohol intake was related to cardiac structure and function, stratified by sex, and fully adjusted for covariates.


Mean age was 76 ± 5 years, 20% were black, and 60% were women. Nondrinkers were older, had lower education level and lower annual income, and were more likely to be diabetic. Drinkers of ≥14 drinks per week were more frequently smokers. The relationship between alcohol consumption and hypertension was U-shaped in both sexes, with hypertension being more frequent among nondrinkers and in those participants drinking ≥14 drinks per week. In both genders, increasing alcohol intake was associated with larger left ventricular (LV) diastolic and systolic diameters and larger left atrial diameter (p < 0.05). In men, increasing alcohol intake was associated with greater LV mass (8.2 ± 3.8 g per consumption category; p = 0.029) and higher E/E′ ratio (0.82 ± 0.33 per consumption category; p = 0.014). In women, increasing alcohol intake was associated with lower LV ejection fraction (−1.9 ± 0.6% per consumption category; p = 0.002) and a tendency for worse LV global longitudinal strain (0.45 ± 0.25% per consumption category; p = 0.07).


In an elderly community-based population, increasing alcohol intake is associated with subtle alterations in cardiac structure and function, with women appearing more susceptible than men to the cardiotoxic effects of alcohol.


As anticipated from findings that women do not metabolize alcohol as well as men, moderate alcohol consumption was associated with modest reduction in systolic function, potentially contributing to a higher risk of alcoholic cardiomyopathy, for any given level of alcohol intake. The contribution of alcohol to systolic function and LV chamber size should always be considered in ischemic and nonischemic cardiomyopathies.

Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Acute Heart Failure, Echocardiography/Ultrasound, Hypertension

Keywords: Aged, Alcohol Drinking, Alcoholic Intoxication, Alcohols, Atherosclerosis, Cardiomyopathy, Alcoholic, Diabetes Mellitus, Diastole, Echocardiography, Geriatrics, Heart Failure, Hypertension, Metabolic Syndrome X, Self Report, Systole

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