Alcohol consumption and incident heart failure in men and women.

Summary

In 407,014 UK Biobank participants followed for a median of 12 years, alcohol consumption showed a J-shaped relationship with incident heart failure. Risk was lowest at ~14 units/week in men and ~7 units/week in women, while beer consumption was associated with higher heart failure risk, particularly in women.

Key Findings

• J-shaped association between total alcohol intake and incident heart failure in both sexes
• Lowest risk at ~14 units/week in men and ~7 units/week in women
• Beer consumption increased heart failure risk, particularly in women (7–14 units/week associated with 29% increased risk)

Clinical Implications

Counsel patients that any potential cardioprotective association of low–moderate alcohol intake is dose- and sex-dependent, and that beer consumption—especially in women—may increase heart failure risk. Shared decision-making should consider individual cardiovascular risk profiles and beverage patterns.

Limitations

• Observational design with potential residual confounding and self-reported alcohol exposure
• Beverage preferences may reflect unmeasured lifestyle or socioeconomic factors

Future Directions

Investigate mechanisms underlying beverage-specific and sex-specific effects; evaluate whether risk patterns differ across genetic or cardiometabolic subgroups to tailor prevention.