Physical Activity and Risk of Atrial Fibrillation: A Nationwide Cohort Study in General Population

Abstract

Although exercise prevents cardiovascular disease and mortality, vigorous exercise and endurance athletics can cause atrial fibrillation (AF). However, no large cohort study has assessed the relationship between physical activity and AF in the general population. We assessed the effect of physical activity at different energy expenditures on the incidence of AF. We studied 501,690 individuals without pre-existing AF (mean age, 47.6 ± 14.3 years; 250,664 women [50.0%]) included in the Korean National Health Insurance Service database. The physical activity level was assessed using a standardized self-reported questionnaire at baseline. During a median follow-up of 4 years, 3,443 participants (1,432 women [41.6%]) developed AF. The overall incidence of AF at follow-up was 1.79 per 1,000 person-years. The subjects who met the recommended physical activity level (500–1,000 metabolic equivalent task [MET] minutes/week) had a 12% decreased AF risk (adjusted hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.80–0.97), but not the insufficiently (1–500 MET-minutes/week; HR: 0.94, 95% CI: 0.86–1.03) and highly active subjects (≥1,000 MET-minutes/week; HR: 0.93, 95% CI: 0.85–1.03). The recommended minimum key target range of physical activity level was associated with the maximum benefit for reduced AF risk in the general population. The dose-response relationship between physical activity level and AF risk showed a U-shaped pattern. Although exceeding the key target range attenuated this benefit, it did not increase the AF risk beyond that during inactivity.

Association between clustering of unhealthy lifestyle factors and risk of new-onset atrial fibrillation: a nationwide population-based study

“…Also, both the frequency and the amount of alcohol consumption per each drinking session showed a positive correlation with a higher risk of AF. Regardless of the intensity of physical activity, low frequency of exercise less than 4 times per week was associated with a higher risk of AF and daily exercise slightly attenuated the benefits of moderate exercise frequency, consistent with previous studies 12,39 . www.nature.com/scientificreports/ Unhealthy lifestyle risk factors are infrequently seen in isolation, and are commonly clustered in the same individual [22][23][24]40 .…”

The impact of physical activity on psychological health during Covid-19 pandemic in Italy

“…In the present work, we analyzed the total MET-min/wk before-and during COVID-19 quarantine and assess the relationship with the psychological well-being of 2524 participants, of which 41.76% was classified as a highly active group. Certainly, our study sample is very limited as compared to other work present in the current literature, such as the work by Jin and coauthors which included more than 500000 individuals, even if the treated topic was different [28]. To date, in Italy is not present a national health monitoring and surveillance system for physical activity, and no studies have collected large data showing the different activity levels of the general public [29].…”

Nonalcoholic fatty liver disease and the risk of atrial fibrillation stratified by body mass index: a nationwide population-based study

“…Fifth, variables such as smoking status, alcohol consumption, and exercise were assessed by self-reported questionnaires, including the national health examination. Although these variables from the Korean NHIS database have been widely used in many previous studies [48][49][50] , there might be a possibility of inaccuracy or recall bias in this information. Lastly, since this is a retrospective observational cohort study, our findings suggest an association between the presence of NAFLD as assessed by FLI with incident AF, but this does not indicate a causal relationship.…”