Abstract
BackgroundAbnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration.MethodsWe studied 7795 men and women from the Third National Health and Nutrition Survey (NHANES III, 1988–1994). Baseline QT interval was measured from the standard 12-lead electrocardiogram. Coffee and tea intake, alcohol consumption, leisure-time physical activities over the past month, and lifetime smoking habits were determined using validated questionnaires during the home interview.ResultsIn the fully adjusted model, the average differences in QT interval comparing participants drinking ≥6 cups/day to those who did not drink any were −1.2 ms (95% CI −4.4 to 2.0) for coffee, and −2.0 ms (−11.2 to 7.3) for tea, respectively. The average differences in QT interval duration comparing current to never smokers was 1.2 ms (−0.6 to 2.9) while the average difference in QT interval duration comparing participants drinking ≥7 drinks/week to non-drinkers was 1.8 ms (−0.5 to 4.0). The age, race/ethnicity, and RR-interval adjusted differences in average QT interval duration comparing men with binge drinking episodes to non-drinkers or drinkers without binge drinking were 2.8 ms (0.4 to 5.3) and 4.0 ms (1.6 to 6.4), respectively. The corresponding differences in women were 1.1 (−2.9 to 5.2) and 1.7 ms (−2.3 to 5.7). Finally, the average differences in QT interval comparing the highest vs. the lowest categories of total physical activity was −0.8 ms (−3.0 to 1.4).ConclusionBinge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors including coffee and tea intake, smoking, and physical activity.
Highlights
Abnormal prolongation or reduction of the electrocardiographic QT interval duration, such as seen in individuals with Mendelian forms of long or short QT syndromes, is associated with increased risk of ventricular arrhythmias and sudden cardiac death [1,2,3,4,5]
Study Population We analyzed data from the Third National Health and Nutrition Examination Survey (NHANES III), a cross-sectional study conducted between 1988 and 1994 that used a multistage stratified clustered probability design to select a representative sample of the civilian non-institutionalized US population [35]
In the fully adjusted model, the average differences in QT interval comparing participants drinking $6 cups/day to those who did not drink any were 21.2 for coffee, and 22.0 ms (211.2 to 7.3) for tea, respectively (Table 2)
Summary
Abnormal prolongation or reduction of the electrocardiographic QT interval duration, such as seen in individuals with Mendelian forms of long or short QT syndromes, is associated with increased risk of ventricular arrhythmias and sudden cardiac death [1,2,3,4,5]. There is substantial uncertainty about the association of modifiable factors, such as coffee intake, cigarette smoking, alcohol consumption, and physical activity with QT interval duration [22,23,24,25,26,27,28,29,30,31,32,33,34]. Several studies have assessed the effect of individual risk factors on QT interval, many of them were small and/or based on selected samples, resulting in inconsistent findings The purpose of this analysis was to investigate the association of coffee, tea, or alcohol intake, smoking, and physical activity with QT interval duration in a large representative sample of the general US population. There is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration
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