February is Cardiovascular Disease Awareness Month!
One often overlooked risk factor for cardiac disease is alcohol consumption. This is because historically it was thought was that moderate drinking was good for the heart and protected against cardiovascular disease. However, those data have largely been refuted in recent years. In fact, the Journal of the American Medical Association (JAMA) published a study in March 2022 concluding that “alcohol consumption of all amounts was associated with increased cardiovascular risk…including those accepted by current national guidelines.”1
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Atrial fibrillation (Afib) is an abnormal heart rhythm affecting close to 12 million Americans. Afib can have devastating consequences, including major stroke and heart failure. Many people with Afib need to be on blood thinners to prevent these outcomes. Other symptoms include heart palpitations, dizziness, extreme fatigue, chest pain, and shortness of breath. Risk factors for developing Afib include advancing age, high blood pressure, diabetes, overactive thyroid, smoking, obesity, and other cardiac diseases.
Alcohol consumption is an important modifiable risk factor to prevent atrial fibrillation:3
- A single drink per day is linked to a 16% higher chance of developing Afib compared to not drinking at all.
- For each additional alcoholic drink consumed each day, the incidence increases by 8%.
- For binge drinking further increases the risk, with estimates of 40-60% of ER visits for Afib caused by binge drinking
Alcohol consumption also decreases the chance of successful treatment of Afib.4 Treatment for Afib most often starts with medications. Sometimes medications alone are not enough so patients need to undergo cardioversion (shocking you out of the rhythm) or a cardiac ablation (procedure to destroy the abnormal heart tissue causing the problem).
Cardioversion success rates:
- >80% for people who do not drink alcohol
- <70% for moderate drinkers
- 35% for heavy drinkers
Ablation success decreases by 7% for each day per week alcohol is consumed.
The Good News!
You have the power to reduce your risk of developing Afib and other cardiac diseases by limiting your alcohol consumption! If you have Afib or are at high risk for developing Afib, it is best to avoid alcohol entirely.
Remember, the risk of developing cardiac disease from alcohol exists at all levels of consumption, even those recommended by the USDA, which is one standard drink per day for women, two standard drinks per day for men under 65, and one standard drink per day for all people over 65.
As a reminder, a standard drink in the US is 14 grams/0.6 fluid ounces of alcohol:5
Dr. Megan McCarren, MD, FASAM is a Board-certified internist and addiction medicine specialist at Saint Alphonsus, Boise.
1. Journal of the American Medical Association March 2022; 5(3):e223749
2. Image source: ecgmedical.com
3. Journal of the American College of Cardiology Dec 2016; 68(23), 2567-2576
4. Canadian Journal of Cardiology 2022 (38), 1352-1363
5. NIAAA (National Institute on Alcohol Abuse and Alcoholism)