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Heartbeat: Chocolate and atrial fibrillation
  1. Catherine M Otto
  1. Correspondence to Professor Catherine M Otto, University of Washington, Division of Cardiology, Seattle, Washington, USA; cmotto{at}, cmotto{at}

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Moderate chocolate consumption has been associated with lower rate of adverse cardiac events and mortality, with the mechanism of this association postulated to be the vasodilatory, antioxidant and anti-inflammatory effects of flavanols in chocolate. Motstofsky and colleagues1 hypothesized that the anti-inflammatory and anti-platelet effects of chocolate might also be associated with a lower rate of atrial fibrillation or flutter (AF). In the over 55 thousand subjects in the population based Danish Diet, Cancer and Health Study, there were 3346 cases of AF (6%) over a median 13.5 years. This data showed that the rate of AF was lower for people consuming chocolate more than once a month, with a hazard ratio (HR) of 0.90 for 1–3 servings/month, HR 0.83 for 1 serving/week, HR 0.80 for 2-6 servings per week and HR 0.84 for ≥1 serving/day, with similar results in women and men. (figure 1) Although confounding effects are difficult to exclude with certainty, the authors conclude that this data suggests that moderate chocolate intake may be inversely associated with AF risk.

Figure 1

Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) according to frequency of chocolate intake in the Danish Diet, Cancer, and Health Study. p trend is the value for linear component of trend. Age was …

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