No Racial Differences in the Association of Cardiorespiratory Fitness With Incident Atrial Fibrillation: Results From the Henry Ford Exercise Testing Project (The Fit Project)

Qureshi, Waqas; Blaha, Michael; Keteyian, Steven J.; Brawner, Clinton A.; Al‐Mallah, Mouaz H.

doi:10.1016/s0735-1097(15)60372-2

Cited by 41 publications

(62 citation statements)

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“…The 13 remaining studies were reviewed in more detail, and we further excluded 7 studies with due to type of publication (1 letter, 1 review, and 5 comments). Finally, 6 studies comprising 205 094 participants and 15 919 AF cases were included in the meta‐analysis (1 post‐hoc analysis of a randomized controlled trial, 4 prospective cohort studies, and 1 retrospective cohort study).…”

Section: Resultsmentioning

confidence: 99%

“…Maximal exercise capacity was expressed in METs or watts (Table ) . Two studies assessed physical fitness using the cycle ergometer, both of which carried out a maximal exercise test .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies assessed physical fitness using the cycle ergometer, both of which carried out a maximal exercise test . Two studies assessed physical fitness using a maximal treadmill exercise test according to the standard Bruce protocol . In the study of Alonso et al, a graded exercise treadmill test was applied, including a maximal test administered at the baseline and a submaximal test administered at years 1 and 4.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, higher exercise capacity estimated by the ergometer bicycle test seems to be associated with an increased risk of AF . In contrast, 5 previous studies have reported an inverse association between physical fitness and the risk of AF, and 2 of the 5 showed no statistically significant association . To date, the corresponding quantitative association has not been established; therefore, we conducted a meta‐analysis to estimate the role of physical fitness on the risk of AF.…”

Section: Introductionmentioning

confidence: 91%

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Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Zhu

Shen²,

Zhou

et al. 2016

Clinical Cardiology

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Several studies have investigated the role of physical fitness in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical fitness and risk of AF. We comprehensively retrieved data from the Cochrane Library, PubMed, and Embase databases until February 29, 2016, for studies evaluating the association of physical fitness with the risk of AF. Data were abstracted from included studies, and effect estimates were pooled using a random-effects model. Six studies with a total of 205 094 participants and 15 919 AF cases fulfilled the inclusion criteria. When physical fitness was assessed as a continuous variable, per incremental increase of physical fitness was associated with a 9% reduced risk of AF (risk ratio [RR]: 0.91, 95% confidence interval [CI]: 0.84-1.00, P = 0.05). When physical fitness was assessed as a categorical variable, the risk of AF was significantly reduced (RR: 0.51, 95% CI: 0.28-0.91, P = 0.02) in individuals with the highest level of physical fitness compared with those with the lowest level. The intermediate vs the lowest level of physical fitness was associated with a 28% reduced risk of AF (RR: 0.72, 95% CI: 0.56-0.93, P = 0.01). The sensitivity analysis indicated that these results were stable. Notably, there was evidence of statistical heterogeneity across studies; therefore, we should interpret the results cautiously. In conclusion, published literature supports that a higher level of physical fitness is associated with a lower risk of AF. Further studies should be performed to confirm these findings.

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Section: Resultsmentioning

confidence: 99%

“…Maximal exercise capacity was expressed in METs or watts (Table ) . Two studies assessed physical fitness using the cycle ergometer, both of which carried out a maximal exercise test .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Zhu

Shen²,

Zhou

et al. 2016

Clinical Cardiology

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“…Our findings are in line with a 2013 study which demonstrated a protective role for walking and running in the development of incident AF 8 , and an analysis of the Cardiovascular Health Study which demonstrated a protective role of leisure time physical activity and low-moderate intensity exercise in development of AF 9 . A recent analysis of the Henry Ford Exercise Testing Project demonstrated an inverse association between cardiorespiratory fitness status and risk of incident AF 19 . Our study supports those findings, and it is certainly possible that, by stratifying by participation in vigorous physical activity, we may have isolated a subset of participants with higher cardiorespiratory fitness.…”

Section: Discussionmentioning

confidence: 99%

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

Bapat

Zhang

Post

et al. 2015

The American Journal of Cardiology

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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.

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Sex Differences in the Association Between Regular Physical Activity and Incident Atrial Fibrillation: A Meta‐analysis of 13 Prospective Studies

Zhu

Wan²,

Din

et al. 2016

Clinical Cardiology

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Several studies investigated the role of physical activity in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical activity and incident AF, as well as to determine whether a sex difference existed. We systematically retrieved relevant studies from Cochrane Library, PubMed, and ScienceDirect through December 1, 2015. Data were abstracted from eligible studies and effect estimates pooled using a random-effects model. Thirteen prospective studies fulfilled inclusion criteria. For primary analysis, neither total physical activity exposure (relative risk [RR]: 0.98, 95% confidence interval [CI]: 0.90-1.06, P = 0.62) nor intensive physical activity (RR: 1.07, 95% CI: 0.93-1.25, P = 0.41) was associated with a significant increased risk of AF. In the country-stratified analysis, the pooled results were not significantly changed. However, in the sex-stratified analysis, total physical activity exposure was associated with an increased risk of AF in men (RR: 1.18, 95% CI: 1.02-1.37), especially at age <50 years (RR: 1.58, 95% CI: 1.28-1.95), with a significantly reduced risk of AF in women (RR: 0.92, 95% CI: 0.87-0.97). Additionally, male individuals with intensive physical activity had a slightly higher (although statistically nonsignificant) risk of developing AF (RR: 1.12, 95% CI: 0.99-1.28), but there was a significantly reduced risk of incident AF in women (RR: 0.92, 95% CI: 0.86-0.98). Published literature supports a sex difference in the association between physical activity and incident AF. Increasing physical activity is probably associated with an increased risk of AF in men and a decreased risk in women.

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No Racial Differences in the Association of Cardiorespiratory Fitness With Incident Atrial Fibrillation: Results From the Henry Ford Exercise Testing Project (The Fit Project)

Cited by 41 publications

References 0 publications

Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta‐Analysis

Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta‐Analysis

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

Sex Differences in the Association Between Regular Physical Activity and Incident Atrial Fibrillation: A Meta‐analysis of 13 Prospective Studies

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