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Greater physical activity linked to lower rates of AF in postmenopausal women
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In postmenopausal women, greater levels of physical activity were associated with lower rates of atrial fibrillation, even in obese women, according to new data from the Women’s Health Initiative observational study.
“The more physically active [the women] were, the less likely it was that they would develop [AF],” Marco V. Perez, MD, independent instructor in cardiovascular medicine and director of the Inherited Arrhythmia Clinic at Stanford University School of Medicine, said in a press release. “Also, the more obese the women were, the more the benefited from having greater degrees of physical activity.”
Perez and colleagues analyzed 81,317 participants from the Women’s Health Initiative to assess the relationship between incident AF, obesity and physical activity.
Mean follow-up was 11.5 years. The annual cumulative incidence of new-onset AF was 1.1%.
Participants had a mean age of 63.4 years, 25.1% were obese, 34.5% were overweight, 3.9% had diabetes and 42.6% had a history of hypertension. Compared with normal-weight women, obese women were more likely to have hypertension (38.8% vs. 15.6%) and diabetes (8.8% vs. 1.4%).
All participants were stratified by physical activity: 13.4% were sedentary, 11.4% performed >0 to 3 metabolic equivalent task hours per week, 22.8% performed >3 to 9 MET-hours per week and 52.4% performed >9 MET-hours per week.
After multivariate adjustment, increased BMI (HR=1.12 per 5 kg/m2 increase; 95% CI, 1.1-1.14) and reduced physical activity (>9 vs. 0 MET-hours per week, HR=0.9; 95% CI, 0.85-0.96) were independently associated with higher rates of AF, the researchers found.
However, the risk for AF conferred by obesity was reduced with higher levels of physical activity (P for interaction=.033).
The results differ from some previous studies. The researchers offered several possibilities as to why. “First, the [Women’s Health Initiative] is particularly well characterized, enabling the inclusion of a more comprehensive list of possible confounders in multivariate regression analyses,” they wrote. “Second, the relatively large number of incident AF outcomes provides significantly greater statistical power than most earlier studies. Third, there are likely diverse pathophysiological mechanisms underlying the development of AF in different patient populations. The [Women’s Health Initiative] participants were older and at higher baseline AF risk than participants in many previous studies. What is considered strenuous physical activity in this population differs from that in young athletes.”
Disclosures: The Women’s Health Initiative program is funded by the NHLBI. The researchers report no relevant financial disclosures.
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