Review: Moderate but regular alcohol consumption can raise risk for AF


People who drink a moderate level of alcohol on a regular basis appear to be at increased risk for atrial fibrillation, according to a review published in the Journal of the American College of Cardiology.

Although moderate consumption of alcohol has been associated with reduced risk for CAD, the same is not true for AF, according to the researchers.

“There has been a lot of attention in recent years about the benefits of drinking small amounts of alcohol for the heart,” Peter Kistler, MBBS, PhD,from the Baker IDI Heart and Diabetes Institute and the Alfred Hospital in Melbourne, Australia, said in a press release. “The results are significant since, chances are, there are people … consuming one or two glasses of alcohol per day that may not realize they are putting themselves at risk for irregular heartbeat.”

Mechanisms of alcohol-associated AF include electrical atrial remodeling, effects on autonomic modulation and causation of tissue fibrosis, Kistler and colleagues wrote.

Although “holiday heart syndrome” — a short-term case of AF after binge drinking — has been previously documented, occasional binge drinking combined with habitual moderate consumption of alcohol confers a similar risk for AF as does habitual heavy drinking, according to the researchers.

An analysis of 859,420 patients who were followed for 12 years showed an 8% increased risk for AF for every alcoholic drink consumed per day, although the relationship was more pronounced with wine and liquor than with beer, Kistler and colleagues wrote.

Another study found risk for AF was elevated by 17% in women who consumed more than 14 standard drinks per week and by 25% in men consuming more than 21 standard drinks per week, they wrote.

Kistler and colleagues also evaluated the relationship between alcohol and other risk factors for AF, including hypertension, obesity, obstructive sleep apnea and cardiomyopathy, concluding that alcohol’s “interaction with other AF risk factors, particularly in habitual drinkers, may be understated.”

One study found consumption of more than 14 standard drinks per week was the strongest risk factor for paroxysmal AF progressing to persistent AF (OR = 3; 95% CI, 1.1-8), Kistler and colleagues wrote.

Studies demonstrating CV benefits of light to moderate alcohol intake “predominantly included healthy adults, and should not be extended to those with a history of AF or structural heart disease,” they wrote.

“Even though we do not have randomized data that tell us what a ‘safe’ amount is to consume, people with an irregular heartbeat should probably drink no more than one alcoholic drink per day, with two alcohol-free days a week,” Kistler said in the release. – by Erik Swain

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