Physical activity and risk of atrial fibrillation in the general population : meta-analysis of 23 cohort studies involving about 2 million participants
Kunutsor, S. K., Seidu, S., Mäkikallio, T. H., Dey, R. S., & Laukkanen, J. A. (2021). Physical activity and risk of atrial fibrillation in the general population : meta-analysis of 23 cohort studies involving about 2 million participants. European Journal of Epidemiology, 36(3), 259-274. https://doi.org/10.1007/s10654-020-00714-4
Published inEuropean Journal of Epidemiology
© The Author(s) 2021
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 fibrillation (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% confidence intervals (CIs) for the maximum versus the minimal amount of physical activity groups were pooled using random-effects 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 modified 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-specific difference in the associations – an increased risk in men and a decreased risk in women. ...
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Additional information about fundingThis study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol (BRC-1215–20011). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. THM acknowledges support from the Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland via the Finnish Governmental Research Funding (VTR) and the Päivikki and Sakari Solhberg Foundation. ...
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