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Atrial fibrillation: Daily alcoholic drink riskier than binge drinking

New research has suggested that drinking daily may harm the heart’s regular rhythm more than binge drinking.

“Recommendations about alcohol consumption have focused on reducing the absolute amount rather than the frequency,” says study author Dr. Jong-Il Choi, a professor in the department of internal medicine at the Korea University College of Medicine in Seoul.

He added that their study suggested that drinking less often may also be important to protect against atrial fibrillation (A-fib).

A-fib is the most common form of heart arrhythmia – a condition where the heart beats too quickly, too slowly, or irregularly.

Prof. Choi observed that “atrial fibrillation is a disease with multiple dreadful complications and significantly impaired quality of life.”

Symptoms can include an irregular or fast pulse, palpitations, shortness of breath, fatigue, dizziness, and chest pain.

A-fib causes and consequences

It can be difficult to say what causes A-fib – however, it seems that damage to the heart’s electrical system is usually to blame. This can occur due to heart disease or as a complication of heart surgery, or other conditions such as chronic uncontrolled high blood pressure.

One of the main effects of the condition is that blood pools in the lower chambers of the heart, which increases the chance of clotting. This is why the risk of stroke is 4 to 5 times higher in people with A-fib.

An earlier analysis discovered that the chances of developing A-fib increased with alcohol consumption. The findings showed that for every 12 grams of alcohol a person consumed per week, there was an 8% higher risk of A-fib. However, this study did not clarify whether the total alcohol consumption or the number of drinking episodes had the strongest effect.

Frequent drinking vs. binge drinking

In the new study, the effect of frequent drinking was compared with that of binge drinking on the risk of new-onset A-fib.

Data on 9,776,956 individuals in the Korean National Health Insurance Service database were analysed. None of the individuals in the analysis had A-fib when, as a part of a health checkup in 2009, they completed a survey about alcohol intake.

By using the records in the database, the team were able to track all of these individuals through to 2017 to identify any occurrences of A-fib. Weekly alcohol consumption was calculated by multiplying the number of drinking sessions per week by the amount of alcohol consumed in each session.

Daily consumption riskier than binge drinking

It was revealed that weekly alcohol intake is a significant risk factor for new-onset A-fib. However, the researchers discovered that the strongest factor was drinking sessions per week. Drinking alcohol daily was associated with a higher risk of A-fib than drinking twice a week, and drinking once a week was even less risky.

Oppositely, no link was discovered between consuming a large amount of alcohol in one session, or binge drinking, and new-onset A-fib. Both of these results held regardless of sex and age.

Prof. Choi suggested that alcohol could trigger an individual episode of A-fib, and if it continues to repeat, it could “lead to overt disease”.

“In addition,” he notes, “drinking can provoke sleep disturbance, which is a known risk factor for [A-fib].”

‘Reduce frequency and weekly consumption’

The results of the study supported those of other studies. They noticed a 2% rise in the risk of new-onset A-fib for each additional weekly gram of alcohol consumption.

The results also demonstrated that mild alcohol intake reduced risk in comparison to both no alcohol consumption and moderate and high levels of consumption.

Individuals who consumed no alcohol or drank moderate to high amounts had elevated risks of new-onset A-fib of 8.6%, 7.7%, and 21.5%, respectively, compared with mild drinkers.

Prof. Choi admits that this may not be a “true benefit,” but could simply be due to other unmeasured variables. Further studies would be required to confirm this.

He suggests that alcohol is likely to be the A-fib risk factor that people can alter most easily, and states that “To prevent new-onset atrial fibrillation, both the frequency and weekly amount of alcohol consumption should be reduced.”

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