Highlights
- •If there is a J shaped relationship between PA and AF remains uncertain.
- •We assessed this relationship in females from the general population.
- •A meta-analytic dose response model was adopted.
- •An inverse non-linear relationship was demonstrated.
- •Up to 50METs- h/w of moderate or vigorous PA seem to safely reduce the risk of AF.
Abstract
Background
For years, physical activity (PA) has been considered a mixed blessing in terms of
the risk of incident atrial fibrillation (AF). Previous analyses have had equivocal
results regarding the cut-off of PA level beyond which AF risk increases, if such
a limit really does exist. Data regarding females in particular have been scarce.
Methods
We performed a dose-response meta-analysis to investigate the relationship between
weekly PA and the risk for AF in females. Major electronic databases were searched
for studies assessing the association between leisure time PA and the risk for incident
AF in females from the general population. The linearity of the dose-response curve
was assessed using the restricted cubic spline model.
Results
A total of 15 studies, which involved 1,821,422 females, were included in the final
analysis. AF incidence was 3.7%. Dose-response analysis revealed an inverse nonlinear
relationship between weekly PA and the risk for incident AF (p for linearity <0.0001).
No significant heterogeneity was documented (I2 = 37%). Cautious interpretation is needed for PA exceeding 50 metabolic equivalents
of task- hours per week (METs- h/w), due to limited available data for these high
levels of PA.
Conclusion
According to this analysis, physicians can safely advise females to perform up to
50METs- h/w of moderate or vigorous PA, to reduce the risk for future AF. Interestingly,
significant benefit can be attained even at low levels of regular weekly PA.
Keywords
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Article info
Publication history
Published online: November 07, 2022
Accepted:
November 2,
2022
Received in revised form:
October 16,
2022
Received:
August 31,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
