Physical Activity and Risk of Atrial Fibrillation: A Nationwide Cohort Study in General Population
Physical Activity and Risk of Atrial Fibrillation: A Nationwide Cohort Study in General Population
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DOI：
10.1038/s41598-019-49686-w
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发表时间：
2019-09-13
影响因子：
4.6
通讯作者：
Joung, Boyoung
中科院分区：
文献类型：
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作者：
Jin, Moo-Nyun;Yang, Pil-Sung;Joung, Boyoung
虽然运动可以预防心血管疾病和死亡，但剧烈运动和耐力运动可能会导致心房颤动 (AF)。然而，尚无大型队列研究评估普通人群中体力活动与房颤之间的关系。我们评估了不同能量消耗下的体力活动对房颤发生率的影响。我们研究了韩国国民健康保险服务数据库中包含的 501,690 名先前没有 AF 的个体（平均年龄，47.6 +/- 14.3 岁；250,664 名女性 [50.0%]）。在基线时使用标准化自我报告问卷评估体力活动水平。在中位随访 4 年期间，3,443 名参与者（1,432 名女性 [41.6%]）出现了 AF。随访时房颤的总体发生率为每 1000 人年 1.79 例。达到推荐体力活动水平（每周 500-1,000 代谢当量任务 [MET] 分钟）的受试者的 AF 风险降低了 12%（调整后风险比 [HR]：0.88，95% 置信区间 [CI]：0.80-0.97），但不充分（每周 1-500 MET 分钟；HR：0.94，95% CI： 0.86-1.03）和高度活跃的受试者（>= 1,000 MET 分钟/周；HR：0.93，95% CI：0.85-1.03）。建议的体力活动水平最低关键目标范围与普通人群降低房颤风险的最大益处相关。体力活动水平与房颤风险之间的剂量反应关系呈 U 形模式。尽管超过关键目标范围会削弱这种益处，但它不会增加超出不活动期间的房颤风险。
Although exercise prevents cardiovascular disease and mortality, vigorous exercise and endurance athletics can cause atrial fibrillation (AF). However, no large cohort study has assessed the relationship between physical activity and AF in the general population. We assessed the effect of physical activity at different energy expenditures on the incidence of AF. We studied 501,690 individuals without preexisting AF (mean age, 47.6 +/- 14.3 years; 250,664 women [50.0%]) included in the Korean National Health Insurance Service database. The physical activity level was assessed using a standardized self-reported questionnaire at baseline. During a median follow-up of 4 years, 3,443 participants (1,432 women [41.6%]) developed AF. The overall incidence of AF at follow-up was 1.79 per 1,000 person-years. The subjects who met the recommended physical activity level (500-1,000 metabolic equivalent task [MET] minutes/week) had a 12% decreased AF risk (adjusted hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.80-0.97), but not the insufficiently (1-500 MET-minutes/week; HR: 0.94, 95% CI: 0.86-1.03) and highly active subjects (>= 1,000 MET-minutes/week; HR: 0.93, 95% CI: 0.85-1.03). The recommended minimum key target range of physical activity level was associated with the maximum benefit for reduced AF risk in the general population. The dose-response relationship between physical activity level and AF risk showed a U-shaped pattern. Although exceeding the key target range attenuated this benefit, it did not increase the AF risk beyond that during inactivity.