Exercise was linked to a lower risk of stroke and death in adults with atrial fibrillation, a 15-year study of more than 87,000 people suggests.
Kristoffer Johansen, lead study author and researcher at UiT The Arctic University of Norway, said: “In general, people with AFib appear to be less active than the general population. The results from our study indicate that physical activity was associated with a reduced risk of stroke and death in individuals with and without atrial fibrillation. So, regular physical activity is important for all and could be an important preventive strategy for people with AFib.”
Atrial fibrillation, also known as AF or AFib, is a quivering or irregular heartbeat that occurs in the heart’s upper chambers, known as the atria.
It can lead to blood clots, stroke and other heart-related conditions.
An estimated 10.55m adults in the US have AFib, equivalent to 4.48 per cent of the adult population.
The American Heart Association recommends that adults spend less time sitting and complete at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity each week.
It also recommends moderate muscle-strengthening activity at least twice a week.
The study followed more than 87,000 adults in Norway for about 15 years, using national health registries to track AFib, stroke and deaths.
Compared with inactive adults, those reporting low levels of physical activity had a 9 per cent lower risk of stroke.
Moderate activity was associated with a 19 per cent lower risk, while high activity was linked to an 18 per cent reduction.
The risk of death from any cause was 11 per cent lower with low activity, 18 per cent lower with moderate activity and 22 per cent lower with high activity.
The associations were similar regardless of whether participants had AFib, suggesting the condition did not alter the relationship between physical activity and stroke.
Among people with AFib, staying active was associated with living an average of 0.5 to 1.2 years longer than being inactive.
Previous research has suggested that people with AFib benefit from regular physical activity, although findings on its association with stroke have been less conclusive.
Johansen said: “I hope our results will increase awareness among clinicians and people with AFib about the benefits of even low levels of physical activity.
“Real health benefits can happen no matter when a person starts getting active, and even a little exercise is better than nothing.”
Mina Chung, co-chair of a 2023 joint guideline on the diagnosis and management of atrial fibrillation from the American Heart Association and other organisations, said the study “adds important evidence linking physical activity with lower risks of stroke and death in people with and without AFib.
“It’s important to remember that physical activity may also reflect overall health. Still, the results motivate patients to be as active as they can – even lower levels of activity were associated with benefit, while moderate to high levels were linked to greater benefit.”
Chung is also a professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and a cardiologist at Cleveland Clinic.
The study included health information from 87,340 participants in two large Norwegian studies.
The HUNT Study included participants from surveys conducted in 2006 to 2008 and 2017 to 2019, while the Tromsø Study included surveys carried out in 2007 to 2008 and 2015 to 2016.
Participants were about 51 years old on average when they enrolled. Around 47 per cent were men and more than 6,500 had AFib.
Researchers divided participants into four groups based on their reported levels of regular physical activity, ranging from inactive to highly active.
They recorded how often people exercised, ranging from never to almost every day, how long they exercised, from less than 15 minutes to more than an hour, and how intensely they exercised.
The study also used a multiple-records approach. People who developed AFib during follow-up were reclassified into the AFib group to improve the accuracy of the analysis.
The study was observational, meaning participants were not randomly assigned to particular exercise levels.
Researchers said other factors that were not measured, or were measured imprecisely, could therefore have influenced the relationship between physical activity and stroke or death.
More active people may also tend to have healthier lifestyles overall. Although researchers adjusted their calculations for several factors, they could not rule out other explanations for the lower risks.
Activity levels were also self-reported, meaning some participants may have reported exercising more than they actually did.
Johansen said he would expect similar results if the analysis were carried out among adults in the US.
Vitamic C may lower MS risk, study suggests
