Physical activity and risk of atrial fbrillation in the general population: meta‑analysis of 23 cohort studies involving about 2 million participants
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Springer
Abstract
Regular 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 fbrillation (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% confdence intervals (CIs) for the maximum versus the minimal amount of physical activity
groups were pooled using random-efects 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 modifed 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-specifc diference in the associations – an
increased risk in men and a decreased risk in women.
Description
Research Article
Keywords
Physical activity, Cardiac arrhythmias, Atrial fibrillation, Cohort study, Risk factor, Systematic review, Meta-analysis