Extra-Virgin Olive Oil Consumption Reduces Risk of Atrial Fibrillation: The PREDIMED Trial

Study Questions:

Does a Mediterranean diet enriched with either extra-virgin olive oil or mixed nuts reduce the incidence of atrial fibrillation?


PREDIMED (PREvención con DIeta MEDiterránea) is a randomized primary prevention trial comparing a Mediterranean diet enriched with either extra-virgin olive oil or mixed nuts with a control diet. In the present study, the outcome of interest was incident atrial fibrillation. Participants (recruited from 11 Spanish University hospitals) were randomly assigned to one of three diets: Mediterranean diet supplemented with extra-virgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident atrial fibrillation was adjudicated during follow-up by an events committee blinded to dietary group allocation. Participants were free of cardiovascular disease and atrial fibrillation at baseline, but were at increased risk for cardiovascular disease defined as having type 2 diabetes, or three or more risk factors (hypertension, current smoking, dyslipidemia, overweight or obesity, and/or family history of premature coronary artery disease).


Baseline characteristics were similar between the three groups. Among the 6,705 participants without prevalent atrial fibrillation at randomization, 72 new cases of atrial fibrillation in the Mediterranean diet with extra-virgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group, were observed after median follow-up of 4.7 years. The Mediterranean diet with extra-virgin olive oil significantly reduced the risk of atrial fibrillation (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.45-0.85) compared to the control group. No effect was found for the Mediterranean diet with nuts (HR, 0.89; 95% CI, 0.65-1.20).


The investigators concluded that in the absence of proven interventions for the primary prevention of atrial fibrillation, this post-hoc analysis of the PREDIMED trial suggests that extra-virgin olive oil in the context of a Mediterranean dietary pattern may reduce the risk of atrial fibrillation.


These data further support the recommendations for a Mediterranean dietary pattern with extra-virgin olive oil for reduction of cardiovascular risk including atrial fibrillation. Understanding the mechanisms of this dietary pattern in reducing incident atrial fibrillation would likely be scientifically important.

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Atherosclerotic Disease (CAD/PAD), Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Diet, Hypertension, Smoking

Keywords: Coronary Artery Disease, Dietary Fats, Unsaturated, Overweight, Diabetes Mellitus, Type 2, Diet, Mediterranean, Smoking, Metabolic Syndrome X, Dyslipidemias, Plant Oils, Spain, Nuts, Cardiovascular Diseases, Obesity, Atrial Fibrillation, Diet, Fat-Restricted, Hypertension, Pregnancy

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