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Alcohol Consumption and Atrial Fibrillation Risk : An Overview of Systematic Reviews and Network Meta-Analysis

Hadi, MohammadHossein ; Saha, Sanjib LU orcid ; Petrie, Dennis LU ; Woode, Maame Esi and Gerdtham, Ulf-Göran LU orcid (2026) In Drug and Alcohol Review 45(1). p.70089-70089
Abstract

ISSUES: Although alcohol consumption is linked to atrial fibrillation (AF), the relationship across different intake levels and between sexes remains unclear. This study presents the first network meta-analysis of prospective cohort studies bringing greater precision to these associations.

APPROACH: A systematic review identified five meta-analyses on alcohol and AF risk. From these, 13 cohort studies totalling over 80 million person-years were included in a random-effects network meta-analysis, including sex-stratified analyses.

KEY FINDINGS: Compared to low-level consumption (< 12 g/day), moderate intake (12-< 24 g/day) slightly increased AF risk (hazard ratio [HR] = 1.07; 95% confidence interval [CI] 1.04-1.10),... (More)

ISSUES: Although alcohol consumption is linked to atrial fibrillation (AF), the relationship across different intake levels and between sexes remains unclear. This study presents the first network meta-analysis of prospective cohort studies bringing greater precision to these associations.

APPROACH: A systematic review identified five meta-analyses on alcohol and AF risk. From these, 13 cohort studies totalling over 80 million person-years were included in a random-effects network meta-analysis, including sex-stratified analyses.

KEY FINDINGS: Compared to low-level consumption (< 12 g/day), moderate intake (12-< 24 g/day) slightly increased AF risk (hazard ratio [HR] = 1.07; 95% confidence interval [CI] 1.04-1.10), similar at 24-< 36 g/day (HR = 1.09; 95% CI 1.00-1.20). No significant risk increase was observed for 36-< 60 g/day. Heavy consumption (≥ 60 g/day) showed the highest risk (HR = 2.84; 95% CI 1.57-5.14). Non-drinkers ('Former', 'Never' or 'Occasional') had HRs near 1, except 'None', which showed a slight increase (HR = 1.08; 95% CI 1.04-1.11).

IMPLICATIONS: In males, moderate consumption increased AF risk slightly, while heavy intake had a more pronounced effect (HR = 1.49; 95% CI 1.22-1.81). In females, moderate intake had no significant effect, but heavy intake significantly increased risk (HR = 2.53; 95% CI 1.05-6.08).

CONCLUSION: This network meta-analysis shows a nonlinear relationship between alcohol consumption and AF risk. Low-level or occasional intake poses the lowest risk. In males, moderate consumption slightly increases AF risk, while in females, risk rises substantially only with heavy intake. These findings support limiting alcohol consumption to reduce AF risk and highlight the need for further sex-stratified studies and consideration of sex-specific recommendations.

REGISTRATION: This network meta-analysis is a split review of an overview of reviews examining alcohol-attributable health and social harms, registered under PROSPERO ID442338.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Atrial Fibrillation/epidemiology, Alcohol Drinking/adverse effects, Risk Factors, Female, Male, Network Meta-Analysis as Topic, Sex Factors
in
Drug and Alcohol Review
volume
45
issue
1
pages
70089 - 70089
publisher
Wiley-Blackwell
external identifiers
  • pmid:41553764
ISSN
0959-5236
DOI
10.1111/dar.70089
language
English
LU publication?
yes
additional info
© 2026 Australasian Professional Society on Alcohol and other Drugs.
id
d4a39ee1-73ce-471b-8fff-3ff0763b1744
date added to LUP
2026-01-20 16:09:21
date last changed
2026-01-20 16:09:21
@article{d4a39ee1-73ce-471b-8fff-3ff0763b1744,
  abstract     = {{<p>ISSUES: Although alcohol consumption is linked to atrial fibrillation (AF), the relationship across different intake levels and between sexes remains unclear. This study presents the first network meta-analysis of prospective cohort studies bringing greater precision to these associations.</p><p>APPROACH: A systematic review identified five meta-analyses on alcohol and AF risk. From these, 13 cohort studies totalling over 80 million person-years were included in a random-effects network meta-analysis, including sex-stratified analyses.</p><p>KEY FINDINGS: Compared to low-level consumption (&lt; 12 g/day), moderate intake (12-&lt; 24 g/day) slightly increased AF risk (hazard ratio [HR] = 1.07; 95% confidence interval [CI] 1.04-1.10), similar at 24-&lt; 36 g/day (HR = 1.09; 95% CI 1.00-1.20). No significant risk increase was observed for 36-&lt; 60 g/day. Heavy consumption (≥ 60 g/day) showed the highest risk (HR = 2.84; 95% CI 1.57-5.14). Non-drinkers ('Former', 'Never' or 'Occasional') had HRs near 1, except 'None', which showed a slight increase (HR = 1.08; 95% CI 1.04-1.11).</p><p>IMPLICATIONS: In males, moderate consumption increased AF risk slightly, while heavy intake had a more pronounced effect (HR = 1.49; 95% CI 1.22-1.81). In females, moderate intake had no significant effect, but heavy intake significantly increased risk (HR = 2.53; 95% CI 1.05-6.08).</p><p>CONCLUSION: This network meta-analysis shows a nonlinear relationship between alcohol consumption and AF risk. Low-level or occasional intake poses the lowest risk. In males, moderate consumption slightly increases AF risk, while in females, risk rises substantially only with heavy intake. These findings support limiting alcohol consumption to reduce AF risk and highlight the need for further sex-stratified studies and consideration of sex-specific recommendations.</p><p>REGISTRATION: This network meta-analysis is a split review of an overview of reviews examining alcohol-attributable health and social harms, registered under PROSPERO ID442338.</p>}},
  author       = {{Hadi, MohammadHossein and Saha, Sanjib and Petrie, Dennis and Woode, Maame Esi and Gerdtham, Ulf-Göran}},
  issn         = {{0959-5236}},
  keywords     = {{Humans; Atrial Fibrillation/epidemiology; Alcohol Drinking/adverse effects; Risk Factors; Female; Male; Network Meta-Analysis as Topic; Sex Factors}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{70089--70089}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Drug and Alcohol Review}},
  title        = {{Alcohol Consumption and Atrial Fibrillation Risk : An Overview of Systematic Reviews and Network Meta-Analysis}},
  url          = {{http://dx.doi.org/10.1111/dar.70089}},
  doi          = {{10.1111/dar.70089}},
  volume       = {{45}},
  year         = {{2026}},
}