Association between high-risk drinking and cardiovascular health based on Life's Essential 8: analysis using 2016-2021 Korean National Health and Nutrition Examination Survey data.

Nearly daily or weekly high-risk drinking was highly prevalent, particularly among men in the Korean adult population studied.

• Nearly daily or weekly high-risk drinking was reported by 37.3% of men and 14.7% of women.
• The study included 18,500 adults aged 19 years or older from the 2016-2021 KNHANES.
• High-risk drinking was defined as consuming seven or more drinks (or five cans of beer) in one sitting for men, and five or more drinks (or three cans of beer) for women, at least once a month.
• A marked sex difference in prevalence of frequent high-risk drinking was observed (37.3% vs 14.7% for men and women, respectively).

Mean cardiovascular health (CVH) scores decreased linearly with increasing frequency of high-risk drinking in both men and women.

• The mean CVH score of groups with more frequent high-risk drinking decreased linearly in both sexes.
• CVH was assessed using the American Heart Association's Life's Essential 8 (LE8) metrics, with total scores ranging from 0 to 100.
• LE8 total scores were categorized as 0–49 (low), 50–79 (moderate), and 80–100 (high) CVH.
• Weighted log-linear regression models were used to analyze the relationship between high-risk drinking frequency and CVH.

Compared to nearly daily high-risk drinkers, men who rarely or never engaged in high-risk drinking had a 14% higher total CVH score.

• Using the 'nearly daily' drinking group as the reference, exp(B)=1.14 (p<0.001) for men in the 'rarely or never' group.
• Men in the 'once a week' high-risk drinking group had a 5% higher total CVH score compared to nearly daily drinkers (exp(B)=1.05, p<0.001).
• A progressive increase in CVH score was observed as frequency of high-risk drinking decreased.
• These associations were derived from weighted log-linear regression models.

Similar trends in CVH score improvement with decreasing high-risk drinking frequency were observed in women, though the effect sizes were slightly different from men.

• Women in the 'rarely or never' high-risk drinking group had a 13% higher total CVH score compared to nearly daily drinkers (exp(B)=1.13, p<0.001).
• Women in the 'once a week' group had a 4% higher total CVH score compared to nearly daily drinkers (exp(B)=1.04, p<0.001).
• The association between high-risk drinking and CVH showed sex differences.
• The magnitude of improvement per step-down in drinking frequency was slightly smaller in women than in men.

The authors concluded that interventions targeting high-risk drinking patterns may be more effective for cardiovascular health than focusing on overall alcohol consumption.

• The study found that high-risk drinking, rather than any alcohol consumption, was the key exposure associated with lower CVH.
• High-risk drinking was specifically defined by occasion-based quantity thresholds (binge-type drinking) rather than total weekly intake.
• The findings suggest that reducing frequency of high-risk drinking occasions is a meaningful cardiovascular health target.
• This was a cross-sectional secondary analysis, limiting causal inference.