Alcohol Consumption and Risk of Atrial Fibrillation: A Prospective Study and Dose-Response Meta-Analysis

Study Questions:

What is the relationship between alcohol consumption and the risk of developing atrial fibrillation (AF)?

Methods:

The study population consisted of 79,019 individuals (43,841 men, ages 45-83 years) in Sweden who completed a health questionnaire that included detailed information on alcohol consumption. AF cases during a mean follow-up of 12 years were identified by linkage with a national registry. Multiple confounding variables were accounted for in the analysis of alcohol intake and AF. The authors also performed a meta-analysis of prospective studies that examined the relationship between alcohol consumption and AF risk.

Results:

Consumption of 15-21 and >21 drinks/week was independently associated with a 14% and 39% greater risk of AF compared to consumption of <1 drink/week, with no gender differences. Liquor and wine consumption were related to AF risk, but not beer consumption. A meta-analysis of seven studies (including the present one) demonstrated a linear relationship between alcohol consumption and AF risk. Overall, there was an 8% increase in AF risk per one drink/day increment in alcohol consumption.

Conclusions:

The authors concluded that the risk of AF rises progressively as the amount of liquor and wine (but not beer) consumption increases.

Perspective:

Alcohol consumption could predispose to AF by direct electrophysiological effects on the myocardium, by causing a cardiomyopathy and atrial dilatation, or by alterations in oxidative stress, electrolytes, blood pressure, or vagal activity. Why beer consumption was not related to AF risk in this study is unclear.

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Atrial Fibrillation/Supraventricular Arrhythmias, Stress

Keywords: Electrolytes, Confounding Factors (Epidemiology), Sweden, Alcoholic Beverages, Cardiomyopathies, Dilatation, Alcohol Drinking, Oxidative Stress, Atrial Fibrillation, Blood Pressure, Questionnaires, Myocardium


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