Association of Physical Activity with the Incidence of Atrial Fibrillation among the Elderly in the Atherosclerosis Risk In Communities (ARIC) Cohort Open Access

Fletcher, Grace (Spring 2020)

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Background: The relationship between physical activity (PA) and atrial fibrillation (AF) remains unclear, especially among the elderly population.

Methods: We studied 4,719 participants of the Atherosclerosis Risk in Communities (ARIC) cohort that took part in its visit 5 (2011-2013), were free of AF and had complete information on all variables.  The exposure for this study was weekly MET-minutes of moderate to vigorous physical activity (MVPA), categorized in tertiles. The outcome was incident AF between the beginning of visit 5 to the end of 2017, ascertained from hospital discharges and death certificates. Time-to-event analysis was used to generate hazard ratios for AF by levels of physical activity adjusting for potential confounders.

Results: The mean (SD) age for the sample was 80.9 (4.9) years, 59% were female and 22% were black. Mean (SD) follow-up time was 5.2 (1.3) years. Compared to those with low weekly MVPA, individuals with moderate weekly MVPA showed a 21% reduction in the hazard of AF (HR= 0.79; 95% CI: 0.63, 0.93) while those with high MVPA showed a smaller 7% reduction in the hazard of AF (HR= 0.93; 95% CI: 0.73, 1.17) when adjusted for all covariates. There was no evidence of heterogeneity when stratified by race and sex.

Conclusion: This analysis suggests that being involved in moderate or high levels of MVPA was associated with reduced hazard of AF, particularly at moderate levels. There was no evidence of increased risk of AF in those with higher levels of MVPA.

Table of Contents

ABSTRACT_________________________________________________________ 1

INTRODUCTION____________________________________________________ 3

METHODS__________________________________________________________ 5

Study Population____________________________________________________ 5

Ascertainment of Physical Activity______________________________________ 5

Ascertainment of Incident Atrial Fibrillation______________________________ 6

Other Covariates____________________________________________________ 6

Statistical Analysis__________________________________________________ 7

RESULTS___________________________________________________________ 8

DISCUSSION_______________________________________________________ 11

CONCLUSION_____________________________________________________ 14

REFERENCES_____________________________________________________ 15

TABLES___________________________________________________________ 17

Table 1. Demographic Characteristics of Study Participants_________________ 17

Table 2. Hazard Ratios (HRs) and Confidence Intervals (CIs) in the Overall Population for the Association between Physical Activity and Atrial Fibrillation______________18

Table 3. Hazard Ratios (HRs) and Confidence Intervals (CIs) Stratified by Race for the Association between Physical Activity and Atrial Fibrillation_____________ 19

Table 4. Hazard Ratios (HRs) and Confidence Intervals (CIs) in Stratified by Sex for the Association between Physical Activity and Atrial Fibrillation_______________ 20


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