We hear conflicting messages about alcohol all the time. Some people praise it’s medicinal virtues while others continually point out all its potential personal and societal harms. Harmful effects range from inebriation, to alcoholic hepatitis, to dementia, to cirrhosis of the liver, and even death. Most people agree that alcoholism is a terrible problem for families everywhere, and leads to family dysfunction, divorce, and juvenile misbehavior. Treating alcohol-related disorders is a full time job.
There is a segment of the medical community that feels alcohol, in moderation, is helpful in the practice of preventive medicine. Multiple studies done decades ago have shown alcohol helps to lower the frequency and severity of hardening of the arteries and stroke. For example, many years ago, before statins, it was recommended high risk patients drink an ounce of whisky at bedtime for the prevention of arteriosclerotic plaques in the walls of the arteries. Well, statins came along, and were actually effective at doing that so alcohol fell out of favor.
Recently, though, alcohol has been implicated as a trigger for “self-reported” atrial fibrillation. Patients who thought they were in AFib trace the onset back to the intake of alcohol. To demonstrate a correlation, portable monitoring devices were used to accurately record heart activity and verify the patient was actually in atrial fib. Other triggers investigated besides alcohol were caffeine, sleep deprivation, dehydration, various hot or cold foods, and exercise. This discussion only deals with alcohol.
Consistently, alcohol was found to be a “significant predictor of risk for self-reported AFib episodes.” This series of studies of AFib triggers also concluded that “the risk rose steadily with the greater number of drinks per week….Light drinkers overall showed no higher AFib risk than nondrinkers.” The type of alcoholic beverage mattered, too. The “modest use of red wine, ie. at least one serving but no more than 7 per week, may have actually protected against new onset AFib, compared with zero intake.”
Low intake levels of white wine didn’t increase risk. “Very low use of liquor or spirits” didn’t increase risk, either. But risk for AFib “went up consistently at any level of beer…consumption, and to be sure, high intake of any alcoholic beverage was associated with greater risk.” The study results came after investigating over “400,000 adults in the community.” The report concluded that it is potentially safer to drink red or white wine as an alternative to other types of alcoholic beverages with respect to AFib risk.”
If you’re hoping to use this info on drinking alcohol to prevent AFib, or at least not cause it, the weekly number of drinks may be fewer than one might expect. Depending on the alcohol content of the beverage, four or fewer drinks per week is the ideal amount.
“It’s important to recognize the overwhelming evidence that alcohol in general increases the risk for atrial fibrillation….perhaps there’s something in wine that is anti-inflammatory that….
overwhelms the proarrhythmic aspect.” In other words, red wine may contain a substance that suppresses whatever it is that triggers the start of AFib. This information makes us wonder if a small amount of alcohol, perhaps red wine, prevents rather than causes AFib.
This is merely a theory at this juncture. Ultimately, a study will be done to determine for certain if, indeed, low amounts of red wine are protective of AFib. The message now is alcohol abstinence is best for secondary AFib prevention, especially if it is a personal trigger. For primary prevention, it appears small amounts of alcohol are permissible.
Dr. G’s Opinion: Alcohol triggers atrial fibrillation in some patients. Conversely, studies have also shown that small amounts of alcohol, especially red wine, have a preventive effect. This phenomenon is specific only to certain individuals. If alcohol gives you AFib, you need to abstain from it completely. If not, small amounts (1-4 drinks/week) of red wine, and some whites, are ok. On the scale of the serious health concerns in life, this is way down on the list. But if you have AFib, you should become familiar with how alcohol affects you individually and behave accordingly. When you know a beer or two, or more, has a tendency to trigger AFib, you’re being stubborn and foolish to continue drinking it. It’s sad to say this, but or some people, drinking too much and triggering AFib may serve as a greater motivation to stop drinking than your wife threatening to leave.
Reference: https://www.mdedge.com/cardiology/article/244052/arrhythmia-news-afib-risk-may-not-rise-light-drinking-may-fail-wine/
