Reduced Incidence of Cardiac Arrhythmias in Walkers and Runners
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Key result
The risk for incident cardiac arrhythmias declined by 4.4% per baseline METhr/d of energy expended during walking or running, with similar risks between walkers and runners who expended comparable energy.
Why the study?
Does higher energy expenditure from walking or running reduce incident self-reported cardiac arrhythmias in adults without prior heart disease?
Population
46,807 adults without pre-existing coronary heart disease or prior arrhythmias.
Comparison
Higher baseline energy expenditure from walking… vs Lower baseline energy expenditure.
Design
Cohort
Follow-up
average 6.2 years
Authors
Discussion
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Implication
Should not yet change arrhythmia prevention practice; extends observational activity data but leaves causality open for RCTs.
Key Points
- This analysis compares the incidence of cardiac arrhythmias in walkers and runners based on their energy expenditure.
- Proportional hazards analysis of 14,734 walkers and 32,073 runners over 6.2 years.
- Self-reported physician-diagnosed cardiac arrhythmias were documented.
- Energy expenditure was measured in metabolic equivalent hours per day.
- 1,060 incident cardiac arrhythmias recorded during follow-up (412 in walkers, 648 in runners).
- Risk declined by 4.4% per baseline METhr/d, specifically 14.2% for 1.8 to 3.6 METhr/d (HR: 0.858) and 31.7% for ≥5.4 METhr/d, compared to <1.8 METhr/d.
- Risk reduction for walking was significantly greater than for running (P<0.01).
Study Design
Type
Cohort (n=46,807)
Structured PICO
Does higher energy expenditure from walking or running reduce incident self-reported cardiac arrhythmias in adults without prior heart disease?
P
Population
46,807 walkers and runners without pre-existing coronary heart disease or prior arrhythmias, followed for an average of 6.2 years to assess incident self-reported physician-diagnosed cardiac arrhythmias.
E
Exposure
Higher baseline energy expenditure (metabolic equivalent hours per day, METhr/d) from walking or running.
C
Comparator
Lower baseline energy expenditure (<1.8 METhr/d, which falls below contemporary physical activity guideline recommendations).
O
Outcome
Incident self-reported physician-diagnosed cardiac arrhythmia (heart rhythm disturbance) during an average 6.2 years of follow-up.patient reported
Main Result
Effect estimate: 4.4% risk reduction per METhr/d
p-value: p=0.0001
Higher energy expenditure from both walking and running is associated with a similar, dose-dependent reduction in the risk of incident self-reported cardiac arrhythmias.
Limitations
- Lack of medical record verification and specificity for atrial fibrillation
- Documented rhythm abnormalities were based on self-report, precluding definitive categorization of the rhythm disturbance
- Study was not designed as a prospective follow-up study, but rather samples were re-surveyed
- Rhythm abnormalities were based on self-report, precluding definitive categorization of the nature of the rhythm disturbance
- Study was not designed as a prospective follow-up study, but rather samples were re-surveyed to provide a base population for a future clinical trial
- Potential misinterpretation of benign sinus bradycardia characteristic of endurance-training as a heart rhythm disturbance
Cite This Study
Williams et al. (2013) conducted a cohort in Cardiac arrhythmias (n=46,807). Energy expenditure from walking and running (METhr/d) vs. Lower energy expenditure (<1.8 METhr/d) was evaluated on Incident self-reported physician-diagnosed cardiac arrhythmias (4.4% risk reduction per METhr/d, p=0.0001). The risk for incident cardiac arrhythmias declined by 4.4% per baseline METhr/d of energy expended during walking or running, with similar risks between walkers and runners who expended comparable energy.
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