Alcohol Consumption and Risk of Incident Atrial Fibrillation in Women

Abstract

Context Previous studies suggest that consuming moderate-to-large amounts of alcohol on a regular basis might increase the risk of developing atrial fibrillation (AF) in men, but not in women. However, these studies were not powered to investigate the association of alcohol consumption and AF among women. Objective To prospectively assess the association between regular alcohol consumption and incident AF among women. Design, Setting and Participants 34715 initially healthy women participating in the Women’s Health Study who were >45 years and free of AF at baseline were prospectively followed from 1993 to October 31, 2006. Alcohol intake was assessed via questionnaires at baseline and 48 months of follow-up and grouped into the following categories: 0, >0 and <1, ≥1 and <2, and ≥2 drinks per day. Main outcome measure Time to a first episode of AF. AF was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review. Results Over a median follow-up of 12.4 years, 653 incident AF cases were confirmed. Age-adjusted incidences among women consuming 0 (n=15370), >0 and <1 (n=15758), ≥1 and <2 (n=2228), and ≥2 (n=1359) drinks per day were 1.59, 1.55, 1.27 and 2.25 events/1000 person-years of follow-up. Thus, compared with non-drinking women, women consuming ≥2 drinks per day had an absolute risk increase of 0.66 events/1000 person-years. The corresponding multivariable-adjusted hazard ratios (HR) (95% confidence interval (CI)) for incident AF were 1.0, 1.05 (0.88–1.25), 0.84 (0.58–1.22) and 1.60 (1.13–2.25), respectively. The increased hazard in the small group of women consuming ≥2 drinks persisted when alcohol intake was updated at 48 months (HR (95% CI) (1.49 (1.05–2.11)) or when women were censored at their first cardiovascular event (HR (95% CI) 1.68 (1.18–2.39)). Conclusion Among healthy middle-aged women, consumption of up to two alcoholic beverages per day was not associated with an increased risk of incident AF. Heavier consumption of two or more drinks per day, however, was associated with a small but statistically significant increased AF risk.

Variations in Cause and Management of Atrial Fibrillation in a Prospective Registry of 15 400 Emergency Department Patients in 46 Countries

“…The study protocol predefined 10 clinical characteristics for the primary analysis: age, hypertension, diabetes mellitus, coronary artery disease, left ventricular dysfunction, heart failure, valvular heart disease, stroke/transient ischemic attack, obesity, and alcohol use, based on previous studies of risk factors. 9,19 Only ≤3 patients had missing data on each of the first eight of these clinical characteristics. Five hundred ninety-four patients (3.86%) had missing data for the calculation of body mass index, and 1333 (8.66%) patients either had missing data or abstained from answering questions about alcohol consumption.…”

Alcohol and arrhythmias: a comprehensive review

“…In the prospective cohort study of 16,415 Danes, the Copenhagen City Heart Study, Mukamel et al, found that alcohol intake of 35 or more drinks per week was associated with higher AF risk in men (15). In the Women's Health Study, Conen et al, found that in healthy middle-aged women, alcohol consumption of up to 2 drinks per day was not associated with increased risk of AF (16).. However, in the subset of women consuming 2 or more drinks, the risk of AF was 1.6 times higher than women who did not consume alcohol.…”

Physio-pathological effects of alcohol on the cardiovascular system: its role in hypertension and cardiovascular disease

“…Alcohol intake is associated with the risk of tachyarrhythmia, such as ventricular and supraventricular premature contractions and atrial fibrillation. 8,[102][103][104] In the Danish Diet, Cancer and Health study, moderate-to-heavy consumption of alcohol was associated with an increased risk of atrial fibrillation. 103,104 Such alcoholinduced arrhythmia often occurs after binge drinking.…”

“…8,[102][103][104] In the Danish Diet, Cancer and Health study, moderate-to-heavy consumption of alcohol was associated with an increased risk of atrial fibrillation. 103,104 Such alcoholinduced arrhythmia often occurs after binge drinking. Activation of the sympathetic nervous system and a decrease in the serum potassium level after drinking may trigger this arrhythmia.…”