Abstract 16750: Access to Alcohol and Heart Disease Among Hospitalized Patients: A Natural Experiment
Background: Alcohol may have important effects on heart disease, but studies have generally relied on self-reported alcohol consumption and have yielded conflicting results. We utilized differences in county-level alcohol sales laws as a natural experiment to investigate the relationship between alcohol consumption and heart disease.
Hypothesis: Wet counties residents have higher rates of atrial fibrillation (AF) and lower rates of myocardial infarction (MI) and congestive heart failure (CHF) related admissions.
Methods: All counties in Texas with no restriction (“wet”) or complete prohibition (“dry”) of alcohol sales or a change in such laws between 2005 and 2010 were identified. Data from the Texas Inpatient Research Data File was used to characterize the hospitalizations of adult residents of those counties. Differences in alcohol use rates were validated using alcohol abuse and alcoholic liver disease outcomes. Adjustment covariates included age, race, ethnicity, sex, diabetes, hypertension, obesity, CHF, CAD, lung disease, and valvular disease.
Results: Among 1,106,968 patients; wet county residents had a greater incidence of alcohol abuse (HR 1.36, 95% CI 1.23-1.50, p <0.001) and alcoholic liver disease (HR of 1.81, 95% CI 1.51-2.16, p <0.001). After adjustment, wet county residents exhibited a greater incidence of AF (HR 1.07, 95% CI 1.01-1.13, p 0.013) and a lower incidence of MI (HR 0.89, 95% CI 0.84-0.96, p 0.001). There was no statistically significance difference in CHF rates (HR 0.96, 95% CI 0.92-1.01, p 0.072). Among the seven counties that converted from dry to wet during the study period, statistically significantly higher rates of alcohol abuse, alcoholic liver disease, AF and CHF were observed after the conversion (Figure).
Conclusions: Greater access to alcohol is associated with more alcohol abuse, alcoholic liver disease and AF, and less MI and CHF, though there is an increased risk of CHF shortly after alcohol sales are liberalized.
Author Disclosures: J.W. Dukes: None. T.A. Dewland: None. E. Vittinghoff: None. J.E. Olgin: None. M.J. Pletcher: None. J.A. Hahn: None. G.M. Marcus: None.
- © 2015 by American Heart Association, Inc.