Absolute abstinence significantly lowers risk of new onset AF among heavy drinkers

Chronic heavy drinkers in middle age who quit alcohol altogether have a significantly lower long-term risk of developing atrial fibrillation (Afib or AF) compared to those who continue heavy drinking, according to a retrospective study conducted in South Korea published in European Journal Of Preventive Cardiology by Dae-In Lee and colleagues. The study also found that practicing harm reduction by reducing alcohol consumption did not generally reduce the risk of Afib.

The nationwide population-based cohort study from South Korea examined data from 19,425 individuals who were free of baseline Afib.

These participants were classified into three groups based on their alcohol consumption changes over time: sustained heavy drinking, reduced drinking, and absolute abstinence. The study followed these individuals from 2013 to 2019 to track incident Afib cases through hospitalization and outpatient records.

● Alcohol Abstinence Benefit: Participants who were former heavy drinkers and had switched to absolute abstinence had a significantly lower risk of new-onset Afib compared to those who continued heavy drinking. The hazard ratio (HR) for the abstinence group was 0.379 (95% CI, 0.169-0.853).

● No Significant Benefit for Harm Reduction: Individuals who practiced harm reduction by reducing their alcohol consumption did not generally experience a reduction in the risk of Afib (HR 0.940, 95% CI, 0.806-1.097). However, those with CHA2DS2-VASc scores under 3 did appear to have reduced incident Afib after drinking less (HR 0.795, 95% CI, 0.642-0.985).

The study's findings emphasize the importance of promoting alcohol abstinence among heavy drinkers, especially in middle age, to reduce the risk of developing Afib. Comprehensive clinical measures and public health policies are recommended to prevent incident Afib in heavy drinkers.

The study highlights the need for alcohol regulation policies such as beverage taxes and limiting accessibility to alcohol to mitigate the high prevalence of heavy alcohol consumption in many countries.

The American dietary guidelines recommend no more than two drinks a day for men and one drink a day for women.

Heavy drinking is defined as eight or more drinks per week for women or 15 or more drinks per week for men by the CDC.

The study relied on self-reported alcohol consumption patterns, and the researchers assumed that participants maintained these habits throughout the follow-up period. The findings are specific to the South Korean population and may not be fully generalizable to other populations.

The study highlights the potential benefits of quitting alcohol entirely for chronic heavy drinkers to reduce the risk of atrial fibrillation. It also underscores the need for public health initiatives and policies to address heavy alcohol consumption. Please note that while the study suggests a link between alcohol abstinence and a reduced risk of Afib, individual health decisions should be made in consultation with healthcare professionals.

Reference:

European Journal of Preventive Cardiology Leea J, et al "Changes in alcohol consumption habits and risk of atrial fibrillation: a nationwide population-based study" Eur J Prev Cardiol 2023; DOI: 10.1093/eurjpc/zwad270.