Friday, 29 March, 2024
HomeCardiologyFrequent drinking greater risk factor for atrial fibrillation than binge drinking

Frequent drinking greater risk factor for atrial fibrillation than binge drinking

Frequent drinking is greater risk factor for heart rhythm disorder than binge drinking. "Recommendations about alcohol consumption have focused on reducing the absolute amount rather than the frequency," said study author Dr Jong-Il Choi, of Korea University College of Medicine and Korea University Anam Hospital, Seoul, Republic of Korea. “Our study suggests that drinking less often may also be important to protect against atrial fibrillation.”

Atrial fibrillation is the most common heart rhythm disorder and raises the risk of stroke by five-fold. Symptoms include palpitations, racing or irregular pulse, shortness of breath, tiredness, chest pain and dizziness.

A prior meta-analysis found a linear correlation between alcohol and atrial fibrillation: risk increased by 8% for every 12 g of alcohol (one drink) consumed per week. But it was not clear which is more important: the total amount of alcohol or the number of drinking sessions.

This study examined the relative importance of frequent drinking versus binge drinking for new-onset atrial fibrillation. The analysis included 9,776,956 individuals without atrial fibrillation who underwent a national health check-up in 2009 which included a questionnaire about alcohol consumption. Participants were followed-up until 2017 for the occurrence of atrial fibrillation.

The number of drinking sessions per week was the strongest risk factor for new-onset atrial fibrillation. Compared with drinking twice per week (reference group), drinking every day was the riskiest, with a hazard ratio (HR) of 1.412, while drinking once a week was the least risky (HR 0.933). Binge drinking did not show any clear link with new-onset atrial fibrillation. “Our study suggests that frequent drinking is more dangerous than infrequent binge drinking with regard to atrial fibrillation,” said Choi. “The number of drinking sessions was related to atrial fibrillation onset regardless of age and sex. Repeated episodes of atrial fibrillation triggered by alcohol may lead to overt disease. In addition, drinking can provoke sleep disturbance which is a known risk factor for atrial fibrillation.”

In keeping with other studies, weekly alcohol consumption was related to atrial fibrillation. There was a 2% increase in the risk of new-onset atrial fibrillation for each gram of alcohol consumed per week. Compared to mild drinkers, those who drank no alcohol, moderate, or high amounts had 8.6%, 7.7%, and 21.5% elevated risks respectively.

Choi said the protective effect of mild drinking needs to be confirmed. “It is not clear if this is a true benefit or a confounding effect of unmeasured variables,” he said. He concluded: “Atrial fibrillation is a disease with multiple dreadful complications and significantly impaired quality of life. Preventing atrial fibrillation itself, rather than its complications, should be our first priority. Alcohol consumption is probably the most easily modifiable risk factor. To prevent new-onset atrial fibrillation, both the frequency and weekly amount of alcohol consumption should be reduced.”

Abstract
Aims: Heavy consumption of alcohol is a known risk factor for new-onset atrial fibrillation (AF). We aimed to evaluate the relative importance of frequent drinking vs. binge drinking.

Methods and results: A total of 9 776 956 patients without AF who participated in a national health check-up programme were included in the analysis. The influence of drinking frequency (day per week), alcohol consumption per drinking session (grams per session), and alcohol consumption per week were studied. Compared with patients who drink twice per week (reference group), patients who drink once per week showed the lowest risk [hazard ratio (HR) 0.933, 95% confidence interval (CI) 0.916–0.950] and those who drink everyday had the highest risk for new-onset AF (HR 1.412, 95% CI 1.373–1.453), respectively. However, the amount of alcohol intake per drinking session did not present any clear association with new-onset AF. Regardless of whether weekly alcohol intake exceeded 210 g, the frequency of drinking was significantly associated with the risk of new-onset AF. In contrast, when patients were stratified by weekly alcohol intake (210 g per week), those who drink large amounts of alcohol per drinking session showed a lower risk of new-onset AF.
Conclusion: Frequent drinking and amount of alcohol consumption per week were significant risk factors for new-onset AF, whereas the amount of alcohol consumed per each drinking session was not an independent risk factor. Avoiding the habit of consuming a low but frequent amount of alcohol might therefore be important to prevent AF.

Authors
Yun Gi Kim, Kyung-Do Han, Jong-Il Choi, Ki Yung Boo, Do Young Kim, Kwang-No Lee, Jaemin Shim, Jin Seok Kim, Young-Hoon Kim

[link url="https://www.sciencedaily.com/releases/2019/10/191017075552.htm"]European Society of Cardiology material[/link]

[link url="https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euz256/5587889"]EP Europace abstract[/link]

MedicalBrief — our free weekly e-newsletter

We'd appreciate as much information as possible, however only an email address is required.