Association of Alcohol Intake with the Incidence of Atrial Fibrillation in Persons >=65 Years Old in the Atherosclerosis Risk in Communities (ARIC) Cohort

BackgroundThe association of alcohol intake with incident atrial fibrillation (AF) remains controversial, particularly among older individuals at higher risk of AF. This study explores the association of alcohol intake with incident AF in persons [≥]65 years old in the Atherosclerosis Risk in Communities (ARIC) cohort. MethodsData were obtained from ARIC, a community-based cohort aiming to identify risk factors for cardiovascular disease. Alcohol intake was assessed through interviewer-administered questionnaires. Incident AF was ascertained between the 2011-2013 visit and 2019. Participants were classified as current, former, or never drinkers. Former drinkers were further categorized on weekly alcohol consumption: light, moderate, heavy. Covariates included demographic characteristics, prevalent cardiovascular disease, and other risk factors. The association between drinking characteristics and incident AF was analyzed using Cox proportional hazard models. ResultsThere were 5,131 participants with mean (SD) age 75.2 (5.0) years, 41% male, 23% Black, and 739 (14%) cases of incident AF. Current (HR 1.04, 95% CI 0.83-1.29) and former (HR 1.16, 95% CI 0.93-1.45) drinkers had a similar risk of incident AF compared to never drinkers. Incident AF was similar across categories of alcohol consumption in former drinkers (heavy drinkers [HR 1.14, 95% CI 0.84-1.55], moderate drinkers [HR 1.15, 95% CI 0.75-1.78) compared to light drinkers). Risk of AF did not differ per 5-year increase in years of abstinence (HR 1.00, 95% CI 0.96-1.03). There was an increase in the risk per 5-year increase in years of drinking (HR 1.07, 95% CI 0.96-1.19). ConclusionWe did not find consistent evidence supporting an increased risk of AF associated with alcohol intake in persons aged 65 and older, highlighting the need to further explore this relationship in older populations.