Association of Physical Activity with the Incidence of Atrial Fibrillation in Persons >65 Years Old: The Atherosclerosis Risk In Communities (ARIC) Study
ABSTRACTBackgroundThough moderate levels of physical activity (PA) seem to reduce the risk of atrial fibrillation (AF), the association of PA with AF in the elderly remains unclear.MethodsWe studied 5,166 participants of the Atherosclerosis Risk in Communities (ARIC) cohort that took part in visit 5 (2011-2013), were free of AF and had complete information on all variables. Self-reported PA was evaluated with a validated questionnaire and weekly minutes of leisure-time moderate to vigorous physical activity (MVPA) were calculated and categorized using the 2018 Physical Activity Guidelines for Americans (no activity [0 min/week], low [>0-<150 min/week], adequate [150-<300 min/week], high [≥300 min/week]). Incident AF between the visit 5 and the end of 2019 was ascertained from hospital discharges and death certificates. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for AF by levels of physical activity adjusting for potential confounders.ResultsThe mean (SD) age for the sample was 75 (5) years; 59% were female and 22% were Black. During a mean (SD) follow-up time of 6.3 (2.0) years, 703 AF events were identified. The association of MVPA with AF incidence showed a U-shaped relationship. Compared to those not engaging in MVPA, individuals with low MVPA had a 23% lower hazard of AF (HR= 0.77; 95% CI: 0.61, 0.96), while those with adequate MVPA had a 14% lower hazard (HR 0.86; 95% CI: 0.69, 1.06). High levels of MVPA were not associated with AF risk (HR 0.97; 95% CI: 0.78, 1.20). There was no evidence of heterogeneity when stratified by race and sex.ConclusionThis study suggests that being involved in low to moderate levels of MVPA was associated with a reduced hazard of AF. There was no evidence of increased risk of AF in those with higher levels of MVPA.