Key result
Midlife obesity independently increased atrial fibrillation risk, whereas the association for cardiorespiratory fitness (HR 0.98; 95% CI 0.96-0.99) was not significant after adjusting for BMI.
Why the study?
The independent contribution of cardiorespiratory fitness and body mass index to the risk of atrial fibrillation is less well established.
Do midlife cardiorespiratory fitness and body mass index independently predict the risk of atrial fibrillation in older age?
Cohort (n=18,493)
Do midlife cardiorespiratory fitness and body mass index independently predict the risk of atrial fibrillation in older age?
Obesity, but not cardiorespiratory fitness, is independently associated with an increased risk of atrial fibrillation in older age.
Midlife obesity supports targeted AF prevention efforts; leaves open independent CRF effects after BMI adjustment.
Background: Lower cardiorespiratory fitness (CRF) and higher body mass index (BMI) are associated with a higher risk of myocardial infarction and heart failure. However, the independent contribution of these lifestyle factors to the risk of atrial fibrillation (AF) is less well established. Objectives: The purpose of this study was to evaluation the association between midlife CRF, BMI, and risk of AF in older age. Methods: This study included 18,493 participants without AF who underwent assessment of CRF (estimated using the maximal treadmill time) and BMI in middle age and had Medicare coverage after the age of 65 years. The association among midlife CRF, BMI, and risk of AF was assessed by fitting a proportional hazards intensity model to the failure time data with adjustment for potential confounders. The association between changes in CRF and BMI in middle age and the risk of AF was also assessed in the subset of participants with repeat CRF assessments. Results: : 1.05; 95% confidence interval: 1.03-1.06). Lower midlife CRF was also associated with higher risk of AF (hazard ratio per 1 MET higher CRF: 0.98; 95% confidence interval: 0.96-0.99). However, this association was attenuated and not significant after further adjustment for BMI. Change in CRF on follow-up was also not associated with the risk of AF after adjustment for other confounders. Conclusions: The association between low fitness and AF was primarily driven by differences in BMI. In contrast, obesity was independently associated with excess AF risk.
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Pandey et al. (2022) conducted a cohort in Atrial fibrillation (n=18,493). Cardiorespiratory fitness and body mass index was evaluated on Risk of atrial fibrillation (HR 0.98, 95% CI 0.96-0.99, p=not significant). Midlife obesity independently increased atrial fibrillation risk, whereas the association for cardiorespiratory fitness (HR 0.98; 95% CI 0.96-0.99) was not significant after adjusting for BMI.
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