University of Oulu

Kunutsor, S.K., Seidu, S., Mäkikallio, T.H. et al. Physical activity and risk of atrial fibrillation in the general population: meta-analysis of 23 cohort studies involving about 2 million participants. Eur J Epidemiol 36, 259–274 (2021). https://doi.org/10.1007/s10654-020-00714-4

Physical activity and risk of atrial fibrillation in the general population : meta-analysis of 23 cohort studies involving about 2 million participants

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Author: Kunutsor, Setor K.1,2; Seidu, Samuel3,4; Mäkikallio, Timo H.5;
Organizations: 1National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
2Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB, UK
3Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK
4Diabetes Research Centre, Leicester General Hospital, University of Leicester, Gwendolen Road, Leicester, LE5 4WP, UK
5Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
6University of Ghana Hospital, Legon, Ghana
7Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
8Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
9Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021051429840
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-05-14
Description:

Abstract

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.

Systematic review registration: PROSPERO 2020: CRD42020172814

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Series: European journal of epidemiology
ISSN: 0393-2990
ISSN-E: 1573-7284
ISSN-L: 0393-2990
Volume: 36
Issue: 3
Pages: 259 - 274
DOI: 10.1007/s10654-020-00714-4
OADOI: https://oadoi.org/10.1007/s10654-020-00714-4
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: This 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.
Copyright information: © The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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