Stay active to prevent stroke and heart rhythm disorders

Physical activity is associated with a lower risk of atrial fibrillation and stroke, according to a study involving more than 15,000 people. The research is presented at ESC Congress 2023.

The most prevalent heart rhythm disorder, atrial fibrillation, affects more than 40 million people globally. According to estimates, one in three Europeans will experience atrial fibrillation at some point in their lives.

In comparison to their peers, patients with the syndrome have a five-fold increased risk of stroke. This study investigated the relationship between fitness and the risk of atrial fibrillation.

The study included 15,450 individuals without atrial fibrillation who were referred for a treadmill test between 2003 and 2012. The average age was 55 years and 59 per cent were men.

Fitness was assessed using the Bruce protocol, where participants are asked to walk faster and at a steeper grade in successive three-minute stages. Fitness was calculated according to the rate of energy expenditure the participants achieved, which was expressed in metabolic equivalents (METs).

Participants were followed for new-onset atrial fibrillation, stroke, myocardial infarction and death. The researchers analysed the associations between fitness and atrial fibrillation, stroke and major adverse cardiovascular events (MACE; a composite of stroke, myocardial infarction and death) after adjusting for factors that could influence the relationships including age, sex, cholesterol level, kidney function, prior stroke, hypertension and medications.

During a median of 137 months, 515 participants (3.3 per cent) developed atrial fibrillation. Each one MET increase on the treadmill test was associated with an 8 per cent lower risk of atrial fibrillation, 12 per cent lower risk of stroke and 14 per centlower risk of MACE.

Participants were divided into three fitness levels according to METs achieved during the treadmill test: low (less than 8.57 METs), medium (8.57 to 10.72) and high (more than 10.72). The probability of remaining free from atrial fibrillation over a five-year period was 97.1 per cent, 98.4 per cent and 98.4 per cent in the low, medium and high fitness groups, respectively.

Study author Dr Shih-Hsien Sung of the National Yang Ming Chiao Tung University, Taipei, Taiwan said, “This was a large study with an objective measurement of fitness and more than 11 years of follow-up. The findings indicate that keeping fit may help prevent atrial fibrillation and stroke.”