Study Finds Consuming Alcohol Linked To Heart-Rhythm Disorder
Using long-term hospital-admissions data from Texas, researchers found an association between alcohol intake and atrial fibrillation
A study comparing hospital admissions in “wet” versus “dry” counties in Texas offers a surprising new perspective on how alcohol consumption may affect the health of the human heart.
The analysis found that people living in dry counties, where sales of alcoholic beverages are prohibited, had a higher risk of being hospitalized for a heart attack or congestive heart failure than people living in wet counties, where such sales are allowed. But residents of wet counties were at elevated risk for a heart rhythm disorder called atrial fibrillation.
The report, published last week in the British Medical Journal (BMJ) is the latest to address a long-running controversy in heart-disease prevention: Does alcohol contribute to, or protect against, heart disease? For a definitive answer, the researchers think it will require connecting a person’s genetic profile with patterns of behavior and exposure to alcohol to understand what an individual’s risk looks like.
Researchers took advantage of the legacy of Prohibition-era laws in Texas to compare heart-related illnesses where access to alcohol had been curbed for decades with illnesses where alcoholic beverages have been commonly available.
The study’s design
For the study, Dr. Marcus and his colleagues analyzed records from a state database of all patients in Texas over 21 years old who were admitted to a hospital between Jan 1, 2005, and Dec. 31, 2009.
During that period, 47 of the state’s 254 counties were wet, 29 were dry, and seven switched from dry to wet. Alcohol sales in the remaining counties were only partially restricted, and researchers excluded those patients.
The analysis included just over 1 million people with at least one hospital admission from wet counties and about 60,000 from dry counties. In the counties that switched, the analysis covers about 43,000 hospitalized patients before the conversion and a similar number after.
The study’s results
The hospital records showed significantly higher misuse of alcohol and cases of alcoholic liver disease in the wet counties – a finding researchers said validated the premise that even though residents of dry counties could obtain alcohol elsewhere, consumption was much lower there.
Differences in heart-related effects between wet and dry counties were modest. Prevalence of atrial fibrillation was about 5% higher in wet counties, while prevalence of heart attacks was 17% lower. New hospitalizations for afib during the study were 7% higher in wet counties while those for heart attack were 9% lower.
In counties that switched from dry to wet during the study period, the risk of new cases of atrial fibrillation was also 7% higher, the researchers found, while heart-attack admissions were similar before and after the change.
That a higher risk of afib was found in both the longtime and recently-converted wet counties was the most consistent and most robust finding in the study.
More broadly, the findings suggest that communities that ease restrictions on alcohol sales can expect more alcohol-related illness, more cases of atrial fibrillation and fewer heart attacks.
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Citation
Dukes Jonathan W, Dewland Thomas A, Vittinghoff Eric, Olgin Jeffrey E, Pletcher Mark J, Hahn Judith A et al. Access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws BMJ 2016; 353 :i2714