Older adults who drank two or more alcoholic beverages each day had changes in cardiac structure and function, according to a large, community-based study.

Lead researcher Alexandra Gonçalves, MD, PhD, of Brigham and Women’s Hospital in Boston, and colleagues found that moderate alcohol consumption for women was associated with a modest reduction in systolic function that could possibly lead to a higher risk of alcoholic cardiomyopathy. They said alcoholic cardiomyopathy was characterized by an enlarged heart, increased left ventricular mass and ventricular dysfunction.

Results were published online in Circulation: Cardiovascular Imaging on May 26.

Researchers defined moderate drinking as one drink per day for women and two for men. Guidelines from the American Heart Association suggest men limit themselves to two alcoholic drinks per day and women have one drink per day.

This analysis was part of the ongoing ARIC (Atherosclerosis Risk in Communities) study that originally included 15,792 adults who were between 45 and 64 years old between 1987 and 1989.

Gonçalves et al evaluated 4,466 surviving patients who underwent transthoracic echocardiography between 2011 and 2013. The mean age was 76, and 60 percent of participants were women.

During their visits, patients were asked if they currently drank alcohol or if they had done so in the past. They were classified by their self-reported alcohol intake: nondrinkers; seven or fewer drinks per week; seven to 14 drinks per week; and more than 14 drinks per week.

Of the participants, 53.7 percent said they did not drink, 32.8 percent said they drank seven or fewer drinks per week, 9 percent drank between seven and 14 drinks per week and 4.4 percent drank more than 14 drinks per week.

Nondrinkers were more likely to be older and diabetic and have a lower education level, lower annual income, lower low-density lipoprotein cholesterol, lower high-density lipoprotein cholesterol and higher triglyceride/high-density lipoprotein cholesterol ratio. Participants who drank at least 14 drinks per week were more likely to be smokers and have higher low-density lipoprotein cholesterol and high-density lipoprotein cholesterol.

Researchers found alcoholic intake was associated with larger diastolic and systolic diameter and larger left atrial diameter. For men, increasing alcohol intake was associated with greater left ventricular mass while it was associated with lower left ventricular ejection fraction in women.

The study had a few limitations, according to the researchers. They said patients may have under-reported their alcohol intake and that the study may not be generalizable to the general population because it only included older adults and not enough black participants to evaluate race-related differences.