Shaan Khurshid1,2,3, Lu-Chen Weng2,3, Mostafa A Al-Alusi1,2,3, Jennifer L Halford2,3,4, Julian S Haimovich2,3,4, Emelia J Benjamin5,6,7, Ludovic Trinquart5,8, Patrick T Ellinor2,3,9, David D McManus10, Steven A Lubitz2,3,9. 1. Division of Cardiology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 8, Boston, MA, 02114, USA. 2. Cardiovascular Disease Initiative, Broad Institute of Harvard University and the Massachusetts Institute of Technology, Cambridge, MA, USA. 3. Cardiovascular Research Center, Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Office 3.188, Boston, MA 02114, USA. 4. Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 8, Boston, MA, 02114, USA. 5. Boston University and National Heart, Lung, and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave, Framingham, MA 01702, USA. 6. Sections of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, 715 Albany St. E-113 Boston, MA 02118, USA. 7. Department of Epidemiology, Boston University School of Public Heath, 801 Mass Ave, Boston, MA 02118, USA. 8. Department of Biostatistics, Boston University School of Public Health, 801 Mass Ave, Boston, MA 02118, USA. 9. Cardiac Arrhythmia Service, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB 109, Boston, MA 02114, USA. 10. Department of Medicine, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655, USA.
Abstract
AIMS: Physical activity may be an important modifiable risk factor for atrial fibrillation (AF), but associations have been variable and generally based on self-reported activity. METHODS AND RESULTS: We analysed 93 669 participants of the UK Biobank prospective cohort study without prevalent AF who wore a wrist-based accelerometer for 1 week. We categorized whether measured activity met the standard recommendations of the European Society of Cardiology, American Heart Association, and World Health Organization [moderate-to-vigorous physical activity (MVPA) ≥150 min/week]. We tested associations between guideline-adherent activity and incident AF (primary) and stroke (secondary) using Cox proportional hazards models adjusted for age, sex, and each component of the Cohorts for Heart and Aging Research in Genomic Epidemiology AF (CHARGE-AF) risk score. We also assessed correlation between accelerometer-derived and self-reported activity. The mean age was 62 ± 8 years and 57% were women. Over a median of 5.2 years, 2338 incident AF events occurred. In multivariable adjusted models, guideline-adherent activity was associated with lower risks of AF [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.75-0.89; incidence 3.5/1000 person-years, 95% CI 3.3-3.8 vs. 6.5/1000 person-years, 95% CI 6.1-6.8] and stroke (HR 0.76, 95% CI 0.64-0.90; incidence 1.0/1000 person-years, 95% CI 0.9-1.1 vs. 1.8/1000 person-years, 95% CI 1.6-2.0). Correlation between accelerometer-derived and self-reported MVPA was weak (Spearman r = 0.16, 95% CI 0.16-0.17). Self-reported activity was not associated with incident AF or stroke. CONCLUSIONS: Greater accelerometer-derived physical activity is associated with lower risks of AF and stroke. Future preventive efforts to reduce AF risk may be most effective when targeting adherence to objective activity thresholds. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Physical activity may be an important modifiable risk factor for atrial fibrillation (AF), but associations have been variable and generally based on self-reported activity. METHODS AND RESULTS: We analysed 93 669 participants of the UK Biobank prospective cohort study without prevalent AF who wore a wrist-based accelerometer for 1 week. We categorized whether measured activity met the standard recommendations of the European Society of Cardiology, American Heart Association, and World Health Organization [moderate-to-vigorous physical activity (MVPA) ≥150 min/week]. We tested associations between guideline-adherent activity and incident AF (primary) and stroke (secondary) using Cox proportional hazards models adjusted for age, sex, and each component of the Cohorts for Heart and Aging Research in Genomic Epidemiology AF (CHARGE-AF) risk score. We also assessed correlation between accelerometer-derived and self-reported activity. The mean age was 62 ± 8 years and 57% were women. Over a median of 5.2 years, 2338 incident AF events occurred. In multivariable adjusted models, guideline-adherent activity was associated with lower risks of AF [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.75-0.89; incidence 3.5/1000 person-years, 95% CI 3.3-3.8 vs. 6.5/1000 person-years, 95% CI 6.1-6.8] and stroke (HR 0.76, 95% CI 0.64-0.90; incidence 1.0/1000 person-years, 95% CI 0.9-1.1 vs. 1.8/1000 person-years, 95% CI 1.6-2.0). Correlation between accelerometer-derived and self-reported MVPA was weak (Spearman r = 0.16, 95% CI 0.16-0.17). Self-reported activity was not associated with incident AF or stroke. CONCLUSIONS: Greater accelerometer-derived physical activity is associated with lower risks of AF and stroke. Future preventive efforts to reduce AF risk may be most effective when targeting adherence to objective activity thresholds. Published on behalf of the European Society of Cardiology. All rights reserved.
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