Alcohol and ideal cardiovascular health: The Multi‐Ethnic Study of Atherosclerosis

BACKGROUND: Alcohol consumption is associated with cardiovascular disease (CVD), with moderate drinkers having decreased CVD risk compared to non‐ and heavy drinkers. However, whether alcohol consumption is associated with ideal cardiovascular health (CVH), assessed by the American Heart Association's (AHA) Life's Simple 7 (LS7) metrics, and whether associations differ by sex, is uncertain. HYPOTHESIS: Heavy alcohol consumption is associated with worse CVH. METHODS: We explored associations between alcohol consumption and CVH in a multi‐ethnic population including 6506 participants free of CVD, aged 45 to 84 years. Each LS7 metric was scored 0 to 2 points. Total score was categorized as inadequate (0‐8), average (9‐10) and optimal (11‐14). Participants were classified as never, former or current drinkers. Current drinkers were categorized as <1 (light), 1 to 2 (moderate) and >2 (heavy) drinks/day. Multinomial logistic regression models assessed associations between alcohol and CVH, adjusted for age, sex, race/ethnicity, education, income, and health insurance. RESULTS: Mean (SD) age was 62 (10) years, 53% were women. Compared to never drinkers, those with >2 drinks/day were less likely to have average [0.61 (0.43‐0.87)] and optimal CVH [0.29 (0.17‐0.49)]. Binge drinking was also associated with unfavorable CVH. Overall, there was no independent association for light or moderate drinking with CVH. However, women with 1 to 2 drinks/day were more likely to have optimal CVH [1.85 (1.19‐2.88)] compared to non‐drinking women, which was not seen in men. CONCLUSION: Heavy alcohol consumption was associated with unfavorable CVH. Although light or moderate drinking may be associated with a more favorable CVH in women, overall, the association was not strong.