Extravirgin olive oil consumption reduces risk of atrial fibrillation: the PREDIMED (Prevención con Dieta Mediterránea) trial

Circulation. 2014 Jul 1;130(1):18-26. doi: 10.1161/CIRCULATIONAHA.113.006921. Epub 2014 Apr 30.


Background: The PREDIMED (Prevención con Dieta Mediterránea) randomized primary prevention trial showed that a Mediterranean diet enriched with either extravirgin olive oil or mixed nuts reduces the incidence of stroke, myocardial infarction, and cardiovascular mortality. We assessed the effect of these diets on the incidence of atrial fibrillation in the PREDIMED trial.

Methods and results: Participants were randomly assigned to 1 of 3 diets: Mediterranean diet supplemented with extravirgin olive oil, Mediterranean diet supplemented with mixed nuts, or advice to follow a low-fat diet (control group). Incident atrial fibrillation was adjudicated during follow-up by an events committee blinded to dietary group allocation. Among 6705 participants without prevalent atrial fibrillation at randomization, we observed 72 new cases of atrial fibrillation in the Mediterranean diet with extravirgin olive oil group, 82 in the Mediterranean diet with mixed nuts group, and 92 in the control group after median follow-up of 4.7 years. The Mediterranean diet with extravirgin olive oil significantly reduced the risk of atrial fibrillation (hazard ratio, 0.62; 95% confidence interval, 0.45-0.85 compared with the control group). No effect was found for the Mediterranean diet with nuts (hazard ratio, 0.89; 95% confidence interval, 0.65-1.20).

Conclusions: In the absence of proven interventions for the primary prevention of atrial fibrillation, this post hoc analysis of the PREDIMED trial suggests that extravirgin olive oil in the context of a Mediterranean dietary pattern may reduce the risk of atrial fibrillation.

Clinical trial registration url: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.

Keywords: antioxidants; arrhythmia; atrial fibrillation; diet; epidemiology; fatty acids, monounsaturated; inflammation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / prevention & control*
  • Diet, Fat-Restricted
  • Diet, Mediterranean*
  • Dietary Fats / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Inflammation
  • Male
  • Middle Aged
  • Nuts
  • Olive Oil
  • Oxidative Stress
  • Plant Oils*
  • Proportional Hazards Models
  • Risk
  • Risk Factors
  • Spain / epidemiology
  • Stroke / epidemiology
  • Stroke / prevention & control
  • Treatment Outcome


  • Dietary Fats
  • Olive Oil
  • Plant Oils

Associated data

  • ISRCTN/ISRCTN35739639