Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway Centre for Clinical Research and Education, University Hospital of North Norway Trust, Tromsø, Norway
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Eur Heart J. 2016 Aug 1;37(29):2307-13. doi: 10.1093/eurheartj/ehw059. Epub 2016 Mar 10.
The objective was to examine the association of physical activity and resting heart rate (RHR) with hospital-diagnosed atrial fibrillation (AF) in a Norwegian cohort.
This prospective study included 20 484 adults (50.3% men) who participated in the third Tromsø Study survey in 1986-87. At baseline, physical activity was assessed by a validated questionnaire, and RHR was objectively measured. Participants were followed from baseline through 2010 with respect to incident cases of hospital-diagnosed AF documented on an electrocardiogram. During a mean follow-up period of 20 years (409 045 person-years), 750 participants (70.5% men) were diagnosed with AF. Compared with the low physical activity group, moderately active individuals had a 19% lower risk of any AF [adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.68-0.97], whereas highly active had similar risk of AF. Vigorously active individuals showed a non-significantly higher risk of AF (adjusted HR 1.37, 95% CI 0.77-2.43). Risk of AF increased with decreasing RHR (adjusted HR 0.92, 95% CI 0.86-0.98 for each 10 b.p.m. increase in RHR), and RHR < 50 b.p.m. was a risk factor for AF (P < 0.05).
In this prospective cohort study, leisure time physical activity was associated with AF in a J-shaped pattern. Moderate physical activity was associated with a reduced risk of AF, whereas higher activity levels attenuated the benefits of moderate activity. Low RHR was a risk factor for AF. Our results support the hypothesis that moderate and vigorous physical activity may affect AF risk via different pathophysiological mechanisms.
本研究旨在探讨挪威队列中体力活动和静息心率（RHR）与医院诊断的心房颤动（AF）之间的关联。
本前瞻性研究纳入了 20484 名成年人（50.3%为男性），他们于 1986-1987 年参加了第三次特罗姆瑟研究调查。在基线时，通过一份经过验证的问卷评估体力活动，并且客观测量 RHR。从基线开始对参与者进行随访，随访时间截止至 2010 年，随访期间记录了心电图上记录的医院诊断为 AF 的新发病例。在 20 年的平均随访期间（409045 人年），有 750 名参与者（70.5%为男性）被诊断为 AF。与低体力活动组相比，中度活跃者的任何 AF 风险降低 19%[调整后的危险比（HR）0.81，95%置信区间（CI）0.68-0.97]，而高度活跃者的 AF 风险相似。非常活跃者的 AF 风险呈非显著升高（调整后的 HR 1.37，95%CI 0.77-2.43）。AF 风险随 RHR 降低而增加（RHR 每增加 10 bpm，调整后的 HR 为 0.92，95%CI 为 0.86-0.98），RHR<50 bpm 是 AF 的危险因素（P<0.05）。
在这项前瞻性队列研究中，休闲时间体力活动与 AF 呈 J 型关联。中度体力活动与 AF 风险降低相关，而更高的活动水平则削弱了中度活动的益处。低 RHR 是 AF 的危险因素。我们的研究结果支持以下假说，即中度和剧烈体力活动可能通过不同的病理生理机制影响 AF 风险。
