The association between alcohol intake and incident atrial fibrillation in older adults: The ARIC cohort

The association of alcohol intake with incident atrial fibrillation (AF) remains controversial, particularly among older adults. This study explores the association of alcohol intake with incident AF in older adults in the Atherosclerosis Risk in Communities (ARIC) cohort. Data were obtained from ARIC, a community-based cohort aimed 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. There 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 and former drinkers had a similar risk of AF compared to never drinkers (HR 1.04, 95% CI 0.83-1.29; HR 1.16, 95% CI 0.93-1.45). Within former drinkers, heavy and moderate drinkers had a similar risk compared to light drinkers (HR 1.14, 95% CI 0.84-1.55; HR 1.15, 95% CI 0.75-1.78). AF risk did not differ per 5-year increase in years of abstinence (HR 1.00, 95% CI 0.96-1.03) or drinking (HR 1.07, 95% CI 0.96-1.19). We did not find consistent evidence supporting an increased risk of AF associated with alcohol intake in older adults, highlighting the need to further explore this relationship in older populations.