Alcohol consumption and risk of atrial fibrillation: Observational and genetic estimates of association
Abstract
BACKGROUND: The aim of this study was to test the hypothesis that alcohol consumption, both observational (self-reported) and estimated by genetic instruments, is associated with a risk of atrial fibrillation and to determine whether people with high cardiovascular risk are more sensitive towards alcohol than people with low risk. METHODS: We used data for a total of 88,782 men and women from the Copenhagen City Heart Study 1991-1994 and 2001-2003 and the Copenhagen General Population Study 2003-2010. Information on incident cases of atrial fibrillation was obtained from a validated nationwide register. As a measure of alcohol exposure, both self-reported consumption and genetic variations in alcohol metabolizing genes (ADH1B/ADH1C) were used as instrumental variables. The endpoint was admission to hospital for atrial fibrillation as recorded in a validated hospital register. RESULTS: A total of 3493 cases of atrial fibrillation occurred during follow-up. High alcohol consumption was associated with a risk of atrial fibrillation among men, but not among women. Among the men who drank 28-35 and 35+ drinks/week, the hazards ratios were 1.40 (95% confidence interval 1.09-1.80) and 1.62 (95% confidence interval 1.27-2.05) compared with men who drank < 1 drink/week. Using genotypes as instrumental variables did not reveal a higher risk. Associations in those with high cardiovascular risk were similar to those at lower risk. CONCLUSIONS: Observational alcohol consumption was associated with a higher risk of atrial fibrillation in men. In women, only a high alcohol intake (28+ drinks/week) was associated with a higher risk. Participants with a high cardiovascular risk were no more sensitive towards alcohol than those at low risk. Genetic analysis did not support a causal relationship of linear association between alcohol intake and atrial fibrillation.
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As different dimensions of alcohol use impact upon cardiovascular outcomes, instrumental variable approaches such as Mendelian randomization cannot answer questions of causality easily, as they assume linear relations with one dimension.
“As different dimensions of alcohol use impact upon cardiovascular outcomes, instrumental variable approaches such as Mendelian randomization cannot answer questions of causality easily, as they assume linear relations with one dimension (for Mendelian randomizations studies see 259, 265; for a discussion of different dimensions of alcohol use with divergent predictions see 266).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [265]
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The relationship between different dimensions of alcohol use and the burden of disease—an update
Rehm, J., Gmel, G. E., Gmel, G., Hasan, O. S. M., Imtiaz, S., Popova, S., Probst, C., Roerecke, M., Room, R., Samokhvalov, A. V., et al. (2017) · Addiction · doi:10.1111/add.13757 · Cited by 1,204 · see citing works
- Authors
- Tolstrup, J. S., Wium-Andersen, M. K., Ørsted, D. D., & Nordestgaard, B. G.
- Affiliations
- University of Southern Denmark (DK)
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Denmark
- University of Copenhagen (DK)
- Corresponding author
- Tolstrup, Janne Schurmann
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-07-10
- Volume
- 23
- Issue
- 14
- Pages
- 1514-1523
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2338196300
- Cited by
- 29
- References
- 37
- Citations by year
- 2026: 3 · 2023: 1 · 2022: 6 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 8 · 2016: 1
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- alcohol consumption, atrial fibrillation, ADH1B, ADH1C, genetic instruments, sex differences, cardiovascular risk, causal relationship, self-reported alcohol intake, hospitalization
- MeSH terms
- Adult, Aged, Alcohol Dehydrogenase, Alcohol Drinking, Atrial Fibrillation, Denmark, Female, Follow-Up Studies, Genetic Testing, Genotype, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Genetic Variation, Incidence, Prevalence, Risk Assessment, Young Adult
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