Relation of Physical Activity and Incident Atrial Fibrillation (from the Multi-Ethnic Study of Atherosclerosis)

Abstract

Prior studies have raised the question of whether an association exists between physical activity and atrial fibrillation (AF). We used the Multi-Ethnic Study of Atherosclerosis (MESA) database to examine the association between physical activity and AF in a diverse population without clinically recognized cardiovascular disease (CVD). MESA participants (N=5793) with complete baseline physical activity and covariate data were included. Cox proportional hazards models were used to calculate hazard ratios (HR) for incident AF by levels of total intentional exercise and vigorous physical activity, independently and in combination. Multivariable models adjusted for demographics and CVD risk factors. During a mean follow-up of 7.7±1.9 years, 199 AF cases occurred. In the overall MESA population, neither vigorous physical activity nor total intentional exercise were independently associated with incident AF after adjusting for covariates. However, within the group that reported any vigorous physical activity, there was a statistically significant inverse association between total intentional exercise (modeled as a continuous variable) and incident AF. Among those who reported any vigorous physical activity, the top tertile of total intentional exercise was associated with a significantly lower risk of incident AF compared with the group with no total intentional exercise in the fully adjusted model (HR 0.46, 95%CI 0.22-0.98). In conclusion, neither total intentional exercise nor vigorous physical activity alone were associated with incident AF, but greater total intentional exercise was associated with a lower risk of incident AF among those that participated in any vigorous physical activity. As importantly, no subgroup of participants demonstrated an increased risk of incident AF with greater physical activity. The results re-emphasize the beneficial role of physical activity for cardiovascular health.

Prevalence of behaviors and risk factors for cardiovascular diseases in hypertensive population in the north of Minas Gerais, Brazil / Prevalência de comportamentos e fatores de risco para doenças cardiovasculares em população de hipertensos no norte de Minas Gerais, Brasil

“…Data from the Multi-Ethnic Study of Atherosclerosis (MESA), concluded that higher levels of physical activity were associated with lower risks of atrial fibrillation. 15 Another important national study observed that the occurrence of in-hospital cardiovascular complication was associated to the time of physical inactivity regardless of age, systolic blood pressure and previous congestive heart failure. 16 The agglomeration of risk factors showed to be similar between men and women according to the study conducted in Brazilian capitals.…”

Physical activity and incidence of atrial fibrillation: A systematic review and meta-analysis

“…A total of 19 studies were included in this review which included 2 post-hoc analysis of randomized controlled trials, [10,12] 10 cohort studies [8,11,16,17,[21][22][23][26][27][28]] and 7 casecontrol studies [7,9,[29][30][31][32][33] with 511,503 participants. The process of study selection is shown in Figure 1.…”

“…[10][11][12]16,[21][22][23][24][25][26][27][28] which could be pooled in meta-analysis these studies showed a borderline significant increase in AF(RR1.98 95%CI 1.00-3.94, I 2 =59%,) ( Figure 4). [7][8][9]29,32,33] Two case-control studies evaluated the approximate hours of physical activity and the study by Calvo et al [30] reported significant increases in AF with more cumulative heavy sports activity (>2000h OR 4.25 95% CI 11.34, 172 participants) while other study by Elosua et al [7] evaluating sports practice found no significant difference with any hours of sports activity.…”

Atrial Fibrillation and Hypertension

“…75 In the MESA cohort, no association was found between vigorous physical activity or total intentional exercise and incident AF, but in a subgroup of patients who reported no vigorous activity, total intentional exercise was associated with a lower AF incidence. 76 When organized in the form of exercise program tailored for age and physical ability, as was done in the CARDIO-FIT study (Impact of Cardiorespiratory Fitness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation), patients who achieved higher cardiorespiratory fitness were less likely to develop recurrent AF, although low cardiorespiratory fitness was an independent predictor of AF recurrence (HR, 2.75; 95% CI, 1.61-4.68). 77 Physical activity not only improved rhythm control but also reduced rates of cardiovascular death, all-cause mortality, and thromboembolic events.…”