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Alcohol consumption linked to greater risk of atrial fibrillation

Regularly consuming large amounts of alcohol increases the risk of developing atrial fibrillation (AF), according to recently published research[1] from a Japanese team led by Drs Satoru Kodama and Hirohito Sone of the Department of Internal Medicine at the University of Tsukuba Institute of Clinical Medicine.

The report, claimed to be “the first to systematically review the literature on the association between alcohol consumption and the risk of AF”, shows through meta-analysis that there is a linear dose-response relationship between alcohol consumption and AF, suggesting that the risk of AF increases proportionally with the amount of alcohol consumed.

drinker2The team conducted a literature search through two databases, MEDLINE (Jan. 1966 to Dec. 2009) and EMBASE (Jan. 1974 to Dec. 2009). They ultimately included 14 observational studies in their investigation, which comprised 130,820 participants and 7,558 cases. Although the definition of heavy drinking varied among the studies, the team limited their analysis to studies that defined the highest intake category as at least 2 drinks per day for men, at least 1 drink per day for women, or participants described as alcoholics (or alcohol abusers). The lowest intake category, or abstainers, was the referent group.

Using statistical analyses, the researchers compared the risk of AF in both the highest alcohol intake group and the lowest alcohol intake group across the 14 studies. They then conducted regression analysis to determine the shape of the relationship between alcohol consumption and AF risk.

The team found that habitual high alcohol intake was shown to be associated with “a significant elevation in AF risk.” This increased risk existed both in the overall analysis and when the researchers conducted stratified analyses based on key study characteristics, such as age, gender, geographic region, study design, and definition of heavy alcohol consumption.

According to the authors, the results suggest that not only episodic but also habitual heavy drinkers have a higher risk of AF compared to non-heavy drinkers. They also assert that, although moderate alcohol intake has been linked to a reduce risk of cardiovascular disease, the linear relationship between alcohol and AF suggests that “not consuming alcohol at all is the most favorable behavior for avoiding AF”.

While the authors do recognize several study limitations—such as the study’s inability to detect the effect of different types of alcoholic beverages, and the possibility of unknown confounders—they note that the research “will have a substantially profound implication on the primary prevention of AF, which is especially important given the sparseness of existing epidemiological evidence, the rapid growth of the occurrence of AF, and the seriousness of AF-specific complications”. They also encourage further investigation into the extent to which the association between alcohol and AF constitutes a causal relationship.


  1. Alcohol Consumption and Risk of Atrial Fibrillation, Sone et al, (J Am Coll Cardiol, 2011; 57:427-436)

Abstract online:

Published on: February 2, 2011

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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