Abstract Body (Do not enter title and authors here): Background: Cardiovascular diseases are the leading cause of death globally today increasing from 14 million deaths in 2000 to 18 million deaths in 2019. Among these 85% of the deaths were from heart attacks. Excessive alcohol use is one of the preeminent preventable causes of death in the US. More than 38 million adults aged 18 and older reported binge drinking and do so on average four times a month. An increased risk of heart attack has been linked to binge drinking or heavy alcohol consumption. This study aims to study the effect of excessive alcohol consumption or binge drinking on heart attacks in the U.S.

Methods: We used cross-sectional data from the 2022 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults aged 18 years and extracted data for non-metropolitan/rural counties. Logistic regression analyses were conducted to test the association between heavy and binge drinking with lifetime reports of experiencing a heart attack. We included the following covariates and controls no health insurance, poor sleep, depression, income, race/ethnicity, educational status, and age. Results: Overall, 5.64% (n=445132) of the participants had heart attacks among the total study population. Neither heavy alcohol use nor binge drinking were significantly associated with experiencing a heart attack. However, age (O. R=7.480 [7.098-7.883]), male gender (O. R=2.192 [2.134-2.253], low income (O. R=1.932 [1.887-1.988]), and depression (O. R=1.445 [1.400-1.491]) were associated with a heart attack.

Conclusion: Despite the widespread concern regarding the link between excessive alcohol consumption and heart attacks, our study found no significant association between heavy alcohol use, binge drinking, and heart attack. However, other covariates like age, male gender, low income, and depression were associated with the prevalence of heart attack which underscores the influence of social determinants of health. Further research is needed to elucidate the nuanced relationship between alcohol consumption patterns and heart health.