Abstract P441: Alcohol Consumption and Incident Heart Failure, Ischemic Heart Disease and Atrial Fibrillation Among Current Drinkers: The All of Us Research Program

Abstract

Background: The Alcohol Use Disorders Identification Test (AUDIT-C) is a clinically validated assessment tool with components that quantify last-year frequency of alcohol use, quantity consumed per drinking day and frequency of binge drinking. We determined the associations between AUDIT-C scores, their components and risks of heart failure (HF), ischemic heart disease (IHD) and atrial fibrillation (AF). Methods: In the NIH-sponsored ‘All of Us’ Research Program, we followed participants free of HF, IHD and AF who had consumed alcohol in the past year. We created Cox proportional hazards models for incident HF, IHD and AF that simultaneously adjusted for all 3 components of the AUDIT-C, sociodemographic factors, prevalent diseases and smoking status. We also created restricted cubic splines (RCS) regression models to determine the dose-response relationships between AUDIT-C scores and incident HF, IHD and AF. Results: The final sample size was 133,025 adults with a mean age of 50 years. There were 1,411 HF, 3793 IHD and 1072 AF cases over a median follow-up of 45 months. RCS demonstrated a J-shape association between total AUDIT-C scores and HF, an L-shaped association with IHD and a positive but non-significant association with AF. For AUDIT-C components, frequency of intake was associated with incident HF and IHD. Compared to drinking monthly or less, drinking 2-4 times/month, 2-3 times/week and 4 or more times per week were all associated with lower risk of incident IHD. Drinking 2-4 times/month and 2-3 times/week were negatively associated with incident HF. We observed no comparable associations of drinking quantity or binge drinking with risk of HF, IHD or AF. Conclusion: The AUDIT-C provides a quick, straightforward, and informative assessment of alcohol consumption. Among current drinkers, drinking frequency is associated with lower risk of HF and IHD but not AF. Greater quantity consumed per drinking day and episodes of binge drinking are not associated with lower risk of major cardiac diseases and should be discouraged.