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

Background: Since evidence regarding the relationship between physical activity (PA) and atrial fibrillation (AF) incidence is inconsistent among studies, we performed a dose–response meta-analysis to comprehensively evaluate the exposure–effect association between PA and incident AF and the potential sex difference in the general population.Methods: The PubMed and Embase databases were searched for eligible studies published up to July 2020 (PROSPERO: CRD42018091692). The non-linear or linear exposure–effect relationship between PA and AF was examined using the robust error meta-regression method.Results: A total of 16 prospective studies involving 1,449,017 individuals and 39,884 AF cases were included. We observed an inverse non-linear association between PA level and incident AF (I2 = 0%, pnon−linearity < 0.001). In the linear model, a 5 metabolic equivalent of task (MET)-h/week increase in PA was associated with a decreased risk of AF [risk ratio (RR) = 0.992, 95% confidence interval (CI): 0.988–0.996, I2 = 0%]. In the sex-stratified analysis, we observed an inverse non-linear relationship between PA level and AF risk in females (I2 = 90%, pnon−linearity < 0.0001) but not in males (I2 = 0%, pnon−linearity = 0.40). In the linear model, a 5 MET-h/week increase in PA was associated with a reduced risk of AF in females (RR = 0.982, 95% CI: 0.975–0.989, I2 = 71%) but not in males (RR = 0.998, 95% CI: 0.994–1.002, I2 = 0%), with a significant interaction observed between the two groups (pinteraction < 0.0001).Conclusion: There was an inverse non-linear relationship between PA level and incident AF in the general population. The beneficial effect of PA in reducing AF risk might be predominantly observed in females.

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Physical activity and risk of atrial fibrillation in the general population: meta-analysis of 23 cohort studies involving about 2 million participants

European Journal of Epidemiology ◽

10.1007/s10654-020-00714-4 ◽

2021 ◽

Author(s):

Setor K. Kunutsor ◽

Samuel Seidu ◽

Timo H. Mäkikallio ◽

Richard S. Dey ◽

Jari A. Laukkanen

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Systematic Review ◽

Cohort Studies ◽

Meta Analysis ◽

Regular Physical Activity ◽

Physically Active ◽

Increased Risk ◽

Observational Cohort

AbstractRegular physical activity is well established to be associated with reduced risk of cardiovascular disease outcomes. Whether physical activity is associated with the future risk of atrial fibrillation (AF) remains a controversy. Using a systematic review and meta-analysis of published observational cohort studies in general populations with at least one-year of follow-up, we aimed to evaluate the association between regular physical activity and the risk of AF. Relevant studies were sought from inception until October 2020 in MEDLINE, Embase, Web of Science, and manual search of relevant articles. Extracted relative risks (RRs) with 95% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using random-effects meta-analysis. Quality of the evidence was assessed by GRADE. A total of 23 unique observational cohort studies comprising of 1,930,725 participants and 45,839 AF cases were eligible. The pooled multivariable-adjusted RR (95% CI) for AF comparing the most physically active versus the least physically active groups was 0.99 (0.93–1.05). This association was modified by sex: an increased risk was observed in men: 1.20 (1.02–1.42), with a decreased risk in women: 0.91 (0.84–0.99). The quality of the evidence ranged from low to moderate. Pooled observational cohort studies suggest that the absence of associations reported between regular physical activity and AF risk in previous general population studies and their aggregate analyses could be driven by a sex-specific difference in the associations – an increased risk in men and a decreased risk in women.Systematic review registration: PROSPERO 2020: CRD42020172814

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Physical activity and risk of cognitive decline: a meta-analysis of prospective studies

Journal of Internal Medicine ◽

10.1111/j.1365-2796.2010.02281.x ◽

2010 ◽

Vol 269 (1) ◽

pp. 107-117 ◽

Cited By ~ 500

Author(s):

F. Sofi ◽

D. Valecchi ◽

D. Bacci ◽

R. Abbate ◽

G. F. Gensini ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Decline ◽

Prospective Studies ◽

Meta Analysis

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

International Journal of Cardiology ◽

10.1016/j.ijcard.2014.09.104 ◽

2014 ◽

Vol 177 (2) ◽

pp. 467-476 ◽

Cited By ~ 47

Author(s):

Chun Shing Kwok ◽

Simon G. Anderson ◽

Phyo K. Myint ◽

Mamas A. Mamas ◽

Yoon K. Loke

Keyword(s):

Physical Activity ◽

Atrial Fibrillation ◽

Systematic Review ◽

Meta Analysis

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Abstract P116: Chronic Kidney Disease And Cardiac Arrhythmias: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.141.suppl_1.p116 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Esther D Kim ◽

Ning Ding ◽

Junichi Ishigami ◽

Xuejuan Ning ◽

Yijing Feng ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Prospective Studies ◽

Cardiac Arrhythmias ◽

Meta Analysis ◽

Case Control ◽

Cross Sectional ◽

The Relationship

Background: Chronic kidney disease (CKD) strongly predicts sudden cardiac death and may elevate the risk of certain cardiac arrhythmias like atrial fibrillation; however, the relationships between CKD and various types of arrhythmia are not well-characterized. Methods: We performed a systematic review and meta-analysis by searching Embase and PubMed for prospective, cross-sectional, and case-control studies examining the associations of two key CKD measures, estimated glomerular filtration rate (eGFR) and albuminuria, with arrhythmias in adults that were published until July 2018. We performed qualitative assessment of studies using the Newcastle Ottawa Quality Assessment Scale. We pooled the results using random-effects models. Results: Among 16,245 articles, we identified 34 prospective (n=24,213,233), 21 cross-sectional (n=253,328), and 4 case-control (n=1,694) studies that included diverse study populations from 19 countries and were mostly high quality. Most prospective studies examined the relationship between eGFR and atrial fibrillation (AF), and demonstrated that lower eGFR was associated with a higher risk of AF (pooled hazard ratio [HR] 1.72 [95% CI: 1.30, 2.27] comparing reduced vs. referent eGFR groups)[ Figure ]. A few studies examined albuminuria and demonstrated its associations with AF (pooled HR 2.16 [95% CI: 1.74, 2.67] comparing high vs. low albuminuria). Results were similar for cross-sectional studies. Four prospective studies reported a higher incidence of ventricular tachycardia resulting in ICD shock according to reduced eGFR (pooled HR 2.32 [95% CI: 1.74, 3.09] comparing reduced vs. referent eGFR groups). Limited number of studies examined other types of arrhythmia. Conclusion: We identified robust data on the relationship between CKD (eGFR and albuminuria) and AF. Reduced eGFR was associated with life-threatening ventricular arrhythmias. Our review highlights the need of future studies for non-AF arrhythmias, especially in the context of albuminuria.

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RE: Physical Activity and the Risk of Liver Cancer: A Systematic Review and Meta-Analysis of Prospective Studies and a Bias Analysis

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz187 ◽

2019 ◽

Vol 112 (6) ◽

pp. 651-652

Author(s):

Haiyan Yang ◽

Li Shi ◽

Ying Wang ◽

Guangcai Duan ◽

Yadong Wang

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Liver Cancer ◽

Prospective Studies ◽

Meta Analysis ◽

Bias Analysis

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Does physical activity reduce the risk of psychosis? A systematic review and meta-analysis of prospective studies

Psychiatry Research ◽

10.1016/j.psychres.2019.112675 ◽

2020 ◽

Vol 284 ◽

pp. 112675 ◽

Cited By ~ 3

Author(s):

Luisa Leonie Brokmeier ◽

Joseph Firth ◽

Davy Vancampfort ◽

Lee Smith ◽

Jeroen Deenik ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Prospective Studies ◽

Meta Analysis

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Impact of Physical Activity on Cognitive Decline, Dementia, and Its Subtypes: Meta-Analysis of Prospective Studies

BioMed Research International ◽

10.1155/2017/9016924 ◽

2017 ◽

Vol 2017 ◽

pp. 1-13 ◽

Cited By ~ 59

Author(s):

Chris B. Guure ◽

Noor A. Ibrahim ◽

Mohd B. Adam ◽

Salmiah Md Said

Keyword(s):

Physical Activity ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Protective Effect ◽

Cognitive Decline ◽

Vascular Dementia ◽

Prospective Studies ◽

Odds Ratio ◽

Meta Analysis ◽

Nonparametric Models

The association of physical activity with dementia and its subtypes has remained controversial in the literature and has continued to be a subject of debate among researchers. A systematic review and meta-analysis of longitudinal studies on the relationship between physical activity and the risk of cognitive decline, all-cause dementia, Alzheimer’s disease, and vascular dementia among nondemented subjects are considered. A comprehensive literature search in all available databases was conducted up until April 2016. Well-defined inclusion and exclusion criteria were developed with focus on prospective studies ≥ 12 months. The overall sample from all studies is 117410 with the highest follow-up of 28 years. The analyses are performed with both Bayesian parametric and nonparametric models. Our analysis reveals a protective effect for high physical activity on all-cause dementia, odds ratio of 0.79, 95% CI (0.69, 0.88), a higher and better protective effect for Alzheimer’s disease, odds ratio of 0.62, 95% CI (0.49, 0.75), cognitive decline odds ratio of 0.67, 95% CI (0.55, 0.78), and a nonprotective effect for vascular dementia of 0.92, 95% CI (0.62, 1.30). Our findings suggest that physical activity is more protective against Alzheimer’s disease than it is for all-cause dementia, vascular dementia, and cognitive decline.

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