Objectives: We investigated the association between alcohol consumption and incident congestive heart failure(CHF) both overall and after adjusting for incident myocardial infarction(MI). Background: Moderate alcohol consumption has been associated with lower risk of CHF and MI. Methods: The Cardiovascular Health study, a prospective cohort study of cardiovascular disease risk factors and outcomes, followed 5,888 subjects ≥65 years old for 7 to 10 years. Cox models were used to estimate the adjusted risk of CHF by reported alcohol consumption. Results: There were 5,595 subjects at baseline at risk for incident CHF with alcohol data and 1,056 events during follow-up. Compared with abstainers, the adjusted risk of CHF was lower among subjects who reported consuming 1 to 6 drinks per week(hazard ratio[HR] 0.82, 95%confidence interval[CI] 0.67 to 1.00, p=0.05) and 7 to 13 drinks per week(HR 0.66, 95%CI 0.47 to 0.91, p=0.01). Time-dependent adjustment for incident MI altered only slightly the association between moderate alcohol consumption and CHF(for 1 to 6 drinks per week, HR 0.84, 95%CI 0.65 to 1.04; for 7 to 13 drinks per week, HR 0.69, 95%CI 0.49 to 0.99). Baseline former drinkers had a higher risk of CHF than abstainers(HR 1.51, p< 0.01), but those who quit during the study did not have a higher risk(HR 0.83, 95%CI 0.66 to 1.03). Conclusions: Moderate alcohol use is associated with a lower risk of incident CHF among older adults, even after accounting for incident MI and other factors. Objectives: We investigated the association between alcohol consumption and incident congestive heart failure (CHF) both overall and after adjusting for incident myocardial infarction (MI). Background: Moderate alcohol consumption has been associated with lower risk of CHF and MI. Methods: The Cardiovascular Health study, a prospective cohort study of cardiovascular disease risk factors and outcomes, followed 5,888 subjects ≥65 years old for 7 to 10 years. Cox models were used to estimate the adjusted risk of CHF by reported alcohol consumption. at baseline at risk for incident CHF with alcohol data and 1,056 events during follow-up. Compared with abstainers, the adjusted risk of CHF was lower among subjects reported consuming 1 to 6 drinks per week (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.67 to 1.00, p = 0.05) and 7 to 13 drinks per week (HR 0.66, 95% CI 0.47 to 0.91, p = 0.01) the association between moderate alcohol consumption and CHF (for 1 to 6 drinks per week, HR 0.84, 95% CI 0.65 to 1.04; for 7 to 13 drinks per week, HR 0.69, 95% CI 0.49 to 0.99). Baseline former drinkers had a higher risk of CHF than abstainers (HR 1.51, p <0.01), but those who quit during the study did not have a higher risk (HR 0.83, 95% CI 0.66 to 1.03). Conclusions: Moderate alcohol use is associated with a lower risk of incident CHF among older adults, even after accounting for incident MI and other factors.