Alcohol intake and incidence of heart failure and its subtypes: VA Million Veteran Program

Researchers studied how total alcohol use and different types of alcoholic drinks relate to the risk of heart failure (HF) in U.S. veterans. They looked at overall heart failure and two main types: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).
The study included 401,348 participants from the Million Veteran Program who had no heart failure at the start and had completed a survey about alcohol use. The average age was 65 years, and 91% were men. Participants were followed for an average of 6.4 years. During that time, 38,420 people developed heart failure.
Compared with people who never drank alcohol, light to moderate drinkers (up to about 3 drinks per day) had a lower risk of heart failure. The lowest risk was seen in those who drank about 1 to 2 drinks per day. However, heavy drinkers (more than 4 drinks per day or those with alcohol use disorder) had a higher risk of heart failure. When looking at heart failure subtypes, the pattern was similar. However, heavy drinking was clearly linked to a higher risk of HFrEF, but not HFpEF. The type of alcohol (beer, wine, or liquor) did not change the relationship between alcohol use and heart failure risk.
The study authors say that their data are consistent with a J-shaped relation between alcohol consumption and risk of heart failure, irrespective of subtypes.
Source: Nguyen X-MT, Elhouderi E, Li Y, Williams AR, Gaziano L, Joseph J, Gaziano JM, Cho K, Djousse L, on behalf of the VA Million Veteran Program. Alcohol Intake and Incidence of Heart Failure and Its Subtypes: VA Million Veteran Program. Nutrients. 2026; 18(3):471.