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Estimated Cardiorespiratory Fitness and Risk of AF
Study Questions:
Is there an association between estimated cardiorespiratory fitness (CRF) and risk of development of atrial fibrillation (AF), and can that risk be affected by long-term changes in estimated CRF?
Methods:
Data from the large, population-based HUNT1 and HUNT2 (The Nord-Trøndelag Health Study), in which 39,844 men and women were enrolled, were analyzed prospectively to determine estimated CRF of individuals and their time to AF diagnosis or date of study endpoint, whichever came first. Baseline estimated CRF was assessed by validated physical activity models and categorized in age-specific quintiles (<40, 40-49, 50-59, 60-69, and ≥70 years old) for each 10-year age group. Changes in estimated CRF were similarly assessed and categorized by type of change observed: decreased, stable, or increased estimated CRF.
Results:
In the main analyses of overall estimated CRF, 17,795 (44.7%) participants were men, and 22,049 (55.3%) were women; the mean ages were 50.6 years and 50.2 years, respectively. In a mean follow-up time of 8.1 years, 1,057 cases of AF were documented. For men, the highest risk reduction for AF was 31% in the fourth quintile of estimated CRF (compared with the first quintile); for women, the highest risk reduction was 47% in the fifth quintile (compared with the first). Overall, 1 metabolic equivalent increase in estimated CRF over a 10-year period was associated with a 7% lower risk of AF and appeared to be more marked in women, although not statistically significant. Participants in the improved estimated CRF group had a 44% risk reduction of developing AF compared with the decreased estimated CRF group.
Conclusions:
The estimated CRF was inversely associated with AF, and participants with improved estimated CRF over a 10-yr period had less risk of AF. These findings support the hypothesis that fitness may prevent AF.
Perspective:
Exercise is good! Physical fitness is inversely related to AF risk and improvement of CRF improves AF risk profile. Furthermore, estimating CRF is a reliable and convenient alternative to direct measurement for AF risk stratification.
Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, Atrial Fibrillation/Supraventricular Arrhythmias, Exercise
Keywords: Physical Fitness, Exercise, Atrial Fibrillation, Risk Assessment, Risk Reduction Behavior
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