Heart · 2014 · 178 citations · 21 references
MedicineCardiologyPhysical ActivityPreventive CardiologyRisk AssessmentAtrial FibrillationCardiovascular RiskPhysical Activity AssessmentPhysical Activity EpidemiologyAge-related Cardiac RiskAtrial Fibrillation Risk AssessmentCox RegressionLeisure-time Physical Activity AssessmentPhysical Activity Attributable RiskPhysical Activity IntensityPhysical Activity QuestionnairesRisk
OBJECTIVE: This study examines the influence of physical activity at different ages and of different types, on the risk of developing atrial fibrillation (AF) in a large cohort of Swedish men. METHODS: Information about physical activity was obtained from 44 410 AF-free men, aged 45-79 years (mean age=60), who had completed a self-administered questionnaire at baseline in 1997. Participants reported retrospectively their time spent on leisure-time exercise and on walking or bicycling throughout their lifetime (at 15, 30 and 50 years of age, and at baseline (mean age=60)). Participants were followed-up in the Swedish National Inpatient Register for ascertainment of AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% CIs, adjusted for potential confounders. RESULTS: During a median follow-up of 12 years, 4568 cases of AF were diagnosed. We observed a RR of 1.19 (95% CI 1.05 to 1.36) of developing AF in men who at the age of 30 years had exercised for >5 h/week compared with <1 h/week. The risk was even higher (RR 1.49, 95% CI 1.14 to 1.95) among the men who exercised >5 h/week at age 30 and quit exercising later in life (<1 h/week at baseline). Walking/bicycling at baseline was inversely associated with risk of AF (RR 0.87, 95% CI 0.77 to 0.97 for >1 h/day vs almost never) and the association was similar after excluding men with previous coronary heart disease or heart failure at baseline (corresponding RR 0.88, 95% CI 0.77 to 0.998). CONCLUSIONS: Leisure-time exercise at younger age is associated with an increased risk of AF, whereas walking/bicycling at older age is associated with a decreased risk.
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External review and validation of the Swedish national inpatient register
Jonas F. Ludvigsson, Eva Andersson, Anders Ekbom et al. · BMC Public Health · 2011 · 5.1K citations · Full text
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Dariush Mozaffarian, Curt D. Furberg, Bruce M. Psaty et al. · Circulation · 2008 · 473 citations · Full text