ArticleNutrients2026
Alcohol Intake and Incidence of Heart Failure and Its Subtypes: VA Million Veteran Program.
Article in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The Impact of Risk Factors and Comorbidities on Heart Failure in the Aging Population.International journal of molecular sciences · 2026Review
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10 authors.
Funding
Abstract
backgroundLittle is known about the relation between total alcohol intake and beverage types with the risk of heart failure (HF) and its subtypes in the veteran population. This study aims to examine the associations between total and type of alcohol consumption and risk of HF and its subtypes, namely HF with reduced [HFrEF] and preserved [HFpEF] ejection fraction, in a large cohort of US veterans.
methodsThe study cohort included 401,348 Million Veteran Program participants with complete alcohol information collected through a survey and no HF at baseline. HF events were defined as 1 inpatient or 1 outpatient diagnosis code together with at least two ejection fraction (EF) measurements. We defined HFrEF as HF with left ventricular ejection fraction (LVEF) of ≤40% and HFpEF as heart failure with LVEF ≥ 50%. The associations between alcohol intake, type of beverage consumed (i.e., beer, wine, or liquor), and incidence of HF, HFpEF, and HFrEF were assessed using Cox proportional hazard models. Restricted cubic spline regression was used to assess for a dose-response association between alcohol consumption and the risk of HF.
resultsMean age was 65 years, and 91% were men. With a mean follow-up of 6.4 years, we observed 38,420 incident HF events (15,356 HFrEF, 19,047 HFpEF, and 4017 HF with an EF value of 41-49%). Compared to never drinkers, multivariable adjusted hazard ratios for HF were 0.90 (95% CI: 0.86, 0.94), 0.88 (95% CI: 0.84, 0.93), 0.86 (95% CI: 0.81, 0.91), 0.92 (95% CI: 0.86, 0.98), 0.95 (95% CI: 0.84, 1.06), and 1.08 (95% CI: 1.01, 1.15) for current drinkers of 0.1-0.5, 0.6-1, 1.1-2, 2.1-3, 3.1-4 drinks/day, and heavy drinkers (i.e., >4 drinks/day and/or those diagnosed with alcohol use disorder), respectively. We found a similar association between alcohol intake and risk of HFpEF and HFrEF, except heavy drinking was significantly associated with HFrEF (HR: 1.13, 95% CI: 1.02, 1.24), not HFpEF (HR: 1.05, 95% CI: 0.96, 1.13). Types of alcoholic beverage preference did not influence the alcohol-HF relation.
conclusionsOur data are consistent with a J-shaped relation between alcohol consumption and risk of heart failure, irrespective of subtypes.
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