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Atrial Fibrillation- The Lifestyle Connection

Updated: Jun 21, 2022

Atrial fibrillation (A-Fib) is a type of abnormal heart rhythm (arrhythmia). Your heart has four chambers that beat in a rhythm: two atria and two ventricles. The atria are the upper chambers. A-Fib happens when the atria beat too fast and irregularly; the atria “quiver” instead of pumping properly.

A-Fib is the most common arrhythmia worldwide. In the United States, there is an overall 25% risk of getting it in your lifetime. The number of people with A-Fib is increasing and is expected to increase further as the population ages.

Who is most likely to get A-Fib? About 70% of people with A-Fib are between 65-85 years old and is more common in men than women.

Symptoms of A-Fib include fatigue, dizziness, shortness of breath, chest pain, and reduced ability to exercise. Although there is a chance you may not experience any symptoms.

Why should we be concerned with A-Fib? People with A-Fib have a steeply increased risk of developing blood clots, heart disease, heart failure, stroke, and death. This is mostly related to the heart's inability to pump around the body properly.

Interesting Fact: Having A-Fib also triples the risk for dementia.

How do you get A-Fib?

There are many risk factors for A-Fib. Some of them you can control, and others you cannot. For example, you can’t control your age, sex, or genetics. However, there are several things you can control, and these are known as “modifiable risk factors.” They include how well you manage certain conditions like type 2 diabetes, cholesterol, high blood pressure, sleep apnea, obesity, etc. Managing these conditions can aid in reducing your chances of developing A-Fib.

Let's talk about the modifiable risk factors:

NOTE: None of these recommendations is a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly.

1. Manage blood sugar and type 2 diabetes

Type 2 diabetes mellitus (T2DM) often coexists with A-Fib. T2DM is a risk factor for heart disease, high blood pressure, cancer, Alzheimer’s, and death. Studies show that people with T2DM can have a 26-34% increased risk of developing A-Fib, especially in women.

There are two factors of T2DM that even further increase the risk of A-Fib:

● The longer someone has had T2DM and,

● When blood sugar levels are poorly controlled (based on HbA1c levels).

NOTE: HbA1c levels are blood tests that your doctor can do to estimate how well your blood sugar has been controlled over the past three months.

One study showed that the combination of T2DM and A-Fib increases the risk of heart disease, stroke, heart failure, and death by 61%. Managing your blood sugar levels is very important for not only reducing complications associated with T2DM but also reducing the chances of developing A-Fib.

2. Manage blood lipids

The science isn’t settled yet on how blood lipid levels affect the risk of A-Fib. Low HDL cholesterol increases the risk of heart disease and heart failure. Both heart disease and heart failure are risk factors for the development of A-Fib.

When it comes to total cholesterol and triglyceride levels, the science is less clear. It’s thought HDL-cholesterol reduces the risk of heart issues because of its ability to reduce inflammation and oxidative stress.

Interestingly, while high doses of niacin (vitamin B3) can increase your HDL cholesterol (which sounds good), too much niacin can increase your risk of A-Fib. You can help increase your HDL-cholesterol levels naturally with a heart-healthy diet, increased omega-3 fat intake, and exercise.

Interesting Fact: Energy drinks typically contain high doses of niacin which could lead to toxicity in the body.

3. Manage high blood pressure

Nearly half of Americans have high blood pressure (hypertension). It’s also a modifiable risk factor for developing A-Fib. How? Hypertension eventually leads to left ventricular hypertrophy (enlargement) and eventually enlargement to the ventricles and atria, which all favor the development of A-fib.

Reducing your blood pressure is not only important for reducing the risk of A-Fib but also reduces the risk of heart failure.

4. Sleep apnea

There is a definite link between obstructive sleep apnea (OSA) and the risk of A-Fib by increasing the risk for left ventricular hypertrophy. About half of people with A-Fib also have OSA.

The usual treatment for OSA is continuous positive airway pressure (CPAP). People with OSA who use the CPAP machines have rates of A-Fib similar to those without OSA. This means that using the machine (if prescribed) can significantly reduce the risk of A-Fib due to OSA. If you are prescribed a CPAP machine, you should use it.

5. Reduce obesity

Obesity is a complex issue and is extremely difficult to manage. So, take this information as an educational understanding of how obesity links with A-Fib, and then move on to the diet and lifestyle factors to reduce the risk of A-Fib.

Studies show that obese people have a 35-49% higher risk of developing A-Fib than non-obese people. In fact, for each unit of BMI increase above normal increases your risk of A-Fib by 4-5%. Obesity’s link to A-Fib is related to the increased workload that is placed on the heart and over time leads to the enlargement of the heart.

Even if you don’t have high blood pressure or T2DM, being overweight still puts you at an increased risk of A-Fib. It’s considered an “independent” risk factor. Obesity also increases your risk of progressing from a short-term “on and off” A-Fib (called “paroxysmal A-Fib”), to constant and permanent A-Fib.

If you’re obese, losing 10% or more of your body weight gives you a six-times better chance of living arrhythmia-free. This is compared with people who lose 3-9% of their body weight. So, aim to lose a bit more weight if you need to.

6. Stop smoking

We all know tobacco is bad for your heart and yes vaping is included. Smoking increases your risk of A-Fib by 40% or more. This is because nicotine increases your heart rate, blood pressure and can also cause arrhythmias.

7. Reduce alcohol

Have you heard of “holiday heart syndrome?” It’s when healthy people drink too much on a holiday or weekend and end up with A-Fib. Holiday heart syndrome is an alcohol-induced arrhythmia. The more alcohol that is consumed, the higher the risk; but even moderate alcohol consumption is a risk factor. For both men and women, your second drink of the day and every one after that increases your risk of A-Fib higher and higher.

There are a few reasons alcohol can cause A-Fib. Alcohol is a “cardiotoxin” which means it has toxic effects on the heart, it can cause arrhythmias especially if electrolytes are disrupted and excessive drinking increases the risk of high blood pressure. To reduce your risk, limit alcohol to no more than 1-2 drinks/day.

8. Caffeine - Some is good, too much is not

Contrary to popular belief, low-to-moderate amounts of caffeine reduce the risk of A-Fib. Excessive amounts, on the other hand, increase the risk. Many people have reported that excess coffee consumption seemed to cause paroxysmal A-Fib.

This also goes for caffeine-containing energy drinks. Several cases of A-Fib have been reported in young people after a high intake of energy drinks. This was especially true when the energy drinks were combined with alcohol. Moderation is key!

9. Get enough moderate exercise

Exercise is great for your heart, right?

There has been a correlation between endurance athletes and increased risks of A-Fib and this is thought to be related to the reduction in “rest time” between atrial beats. However, moderate-intensity exercise reduces the risk of A-Fib. An example of moderate exercise is walking or bicycling at a moderate pace for 40+ minutes per day.

Overall, exercise increases your quality of life, aids in the weight loss and development of T2DM, HTN, and OSA.


Atrial fibrillation is a serious condition where your heart doesn’t beat properly (arrhythmia). It increases your risk of many other conditions such as heart attack, stroke, and death. The risk of A-Fib increases with many conditions including type 2 diabetes, blood lipids, high blood pressure, sleep apnea, and obesity. Managing these conditions is important for A-Fib. There are also several diet and lifestyle factors you can improve. These include quitting smoking, reducing alcohol intake, reducing caffeine intake, and incorporating moderate exercise into your daily routine.

Reform ABQ can help you manage your chronic conditions and perhaps get you on the right path to prevent A-Fib in the future. Getting an appointment is easy, just click the button below:


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