“Our new data suggest that acute alcohol consumption in the general population is associated with a higher risk of an episode of atrial fibrillation, including a higher risk for a first episode of atrial fibrillation among individuals never previously diagnosed with the condition,” said the senior study author Gregory Marcus, MD, a professor of medicine at UCSF and an associate chief of cardiology for research at UCSF Health, in a press release.
About 1 in 6 U.S. Adults Binge Drink
“Worldwide, alcohol is the most popularly consumed drug, and it now is clear that alcohol consumption is an important risk factor for atrial fibrillation,” said Dr. Marcus. The 2020–2025 Dietary Guidelines for Americans recommend that adult men limit their intake to two drinks or less in a day and that women have one drink or less a day. In health terms, excessive drinking includes binge drinking and heavy drinking. Binge drinking is when you consume more than four (for women) or five (for men) drinks at a single occasion. It’s estimated that about one in six U.S. adults binge drink, with about 25 percent of those people doing so at least weekly, and about 25 percent consuming at least eight drinks during a binge occasion, according to the CDC.
Afib Can Lead to Many Serious Heart Events, Including Stroke, Blood Clots, and Heart Failure
It’s estimated that at least 2.7 million Americans have afib, which is a quivering or irregular heartbeat (arrhythmia), though the true number may be higher than that, partly because some people have afib and don’t know it. The failure to seek diagnosis or treatment can be because they don’t have any symptoms, or they don’t recognize them, according to the American Heart Association (AHA). When symptoms are present, they can include tiredness and weakness, rapid and irregular heartbeat or fluttering in the chest, and shortness of breath and anxiety. In a normal heart, the range for a heart rate is typically 60 to 100 beats per minute; the heart rate in afib can range from 100 to 175 beats a minute.
An Uptick in Drinking and Breathalyzer Use Found on New Year’s Day, Christmas, MLK Day, and Super Bowl Sunday
To find out whether binge drinking was associated with an increase in ER visits for atrial fibrillation, researchers first worked to identify days when people are likely to drink more alcohol. Researchers used data obtained through a commercially available Bluetooth-enabled breathalyzer device, gathering information (without individual identifiers) from 36,158 people from all 50 states and 59 countries, resulting in a total of 1,269,054 breath alcohol measurements. They found that the top eight holidays or national events in which people used the devices significantly more often or had higher breathalyzer measurements included New Year’s Day, Martin Luther King Jr. Day, Super Bowl Sunday, the first day of daylight saving time, July 4, Christmas, the FIFA World Cup, and Father’s Day.
Higher Number of Afib Hospital Visits Occurred on Higher Drinking Days
To see if there was a relationship between greater alcohol consumption and AF diagnosis, researchers accessed records from the California Office of Statewide Health Planning and Development (OSHPD) of hospital emergency room visits between January 1, 2005, and December 30, 2015, and identified visits coded for an AF diagnosis. After comparing the weeks associated with greater alcohol consumption to all other weeks of the year, investigators found that there was a significantly elevated number of hospital visits for AF on the previously identified “higher drinking days” compared with all other days of the year. The results remained significant when researchers compared all other days of the year versus each of the following events alone: New Year’s Day, the start of daylight savings time, Super Bowl Sunday, and Christmas. Experts who care for people with afib realize that this happens, says Hugh Calkins, MD, the director of the cardiac arrhythmia service and a professor of medicine at Johns Hopkins Medicine in Baltimore. “I always tell patients that on New Year’s Day, emergency rooms are filled with people with afib from too much drinking. This study does a good job in further exploring what we call the ‘holiday heart’ syndrome,” says Dr. Calkins. People should be aware of this risk, he says. “We’ve done a good job with encouraging people to ‘know their numbers’ when it comes to cholesterol or high blood pressure, and we need to increase people’s awareness about their heart rhythm — if it’s chaotically irregular, you may have atrial fibrillation, and you can get a noninvasive test to diagnose it,” says Calkins. Diagnosis and treatment are important for stroke prevention and other problems that can come with afib, he adds. In addition to stroke, afib can lead to blood clots, heart failure, and other heart-related conditions, per the AHA. There are many medications and lifestyle modifications that can slow the heart rate and reduce the risk of stroke or other event. To further strengthen the results, the researchers used a different but still common heart problem, supraventricular tachycardia, as a “negative control” to see if the same link with drinking would exist. The analysis revealed there was none, which suggests there is something indeed uniquely important about alcohol as a risk factor for acute atrial fibrillation, rather than alcohol as a general determinant of a medical visit or even all heart rhythm problems, according to Marcus.
Greatest Association Between Excessive Alcohol Consumption and Afib Visits in People Over 65
To analyze the incidence of afib hospital-visit rates according to race or ethnicity, gender, and age, the researchers used California census data and found the greatest association between acute alcohol consumption and hospital visits for afib among those over age 65. In addition to older age and binge drinking, high blood pressure, underlying heart disease, family history, sleep apnea, chronic conditions such as thyroid issues, diabetes, and asthma increase the risk of afib, per the AHA. Further analysis revealed increases in afib hospital visits on the heavy drinking days were higher in people without a previous diagnosis. This finding suggests that many new cases of AF are triggered specifically by acute alcohol consumption, said Marcus. “This may be kind of a wake-up call for those individuals who have an identifiable trigger for their atrial fibrillation, who we might presume would be more highly motivated to avoid alcohol consumption and subsequently to experience a lowering of their atrial fibrillation risk,” he said.
