Obesity, Physical Activity, and Their Interaction in Incident Atrial Fibrillation in Postmenopausal Women

Medientyp: E-Artikel
Titel: Obesity, Physical Activity, and Their Interaction in Incident Atrial Fibrillation in Postmenopausal Women
Beteiligte: Azarbal, Farnaz; Stefanick, Marcia L.; Salmoirago‐Blotcher, Elena; Manson, JoAnn E.; Albert, Christine M.; LaMonte, Michael J.; Larson, Joseph C.; Li, Wenjun; Martin, Lisa W.; Nassir, Rami; Garcia, Lorena; Assimes, Themistocles L.; Tharp, Katie M.; Hlatky, Mark A.; Perez, Marco V.
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2014
Erschienen in: Journal of the American Heart Association
Sprache: Englisch
DOI: 10.1161/jaha.114.001127
ISSN: 2047-9980
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Beschreibung: <jats:sec xml:lang="en"><jats:title>Background</jats:title><jats:p xml:lang="en">Atrial fibrillation (<jats:styled-content style="fixed-case">AF</jats:styled-content>) is the most common cardiac arrhythmia and is associated with increased risk of stroke and death. Obesity is an independent risk factor for<jats:styled-content style="fixed-case">AF</jats:styled-content>, but modifiers of this risk are not well known. We studied the roles of obesity, physical activity, and their interaction in conferring risk of incident<jats:styled-content style="fixed-case">AF</jats:styled-content>.</jats:p></jats:sec><jats:sec xml:lang="en"><jats:title>Methods and Results</jats:title><jats:p xml:lang="en">The Women's Health Initiative (<jats:styled-content style="fixed-case">WHI</jats:styled-content>) Observational Study was a prospective observational study of 93 676 postmenopausal women followed for an average of 11.5 years. Incident<jats:styled-content style="fixed-case">AF</jats:styled-content>was identified using<jats:styled-content style="fixed-case">WHI</jats:styled-content>‐ascertained hospitalization records and diagnostic codes from Medicare claims. A multivariate Cox's hazard regression model adjusted for demographic and clinical risk factors was used to evaluate the interaction between obesity and physical activity and its association with incident<jats:styled-content style="fixed-case">AF</jats:styled-content>. After exclusion of women with prevalent<jats:styled-content style="fixed-case">AF</jats:styled-content>, incomplete data, or underweight body mass index (<jats:styled-content style="fixed-case">BMI</jats:styled-content>), 9792 of the remaining 81 317 women developed<jats:styled-content style="fixed-case">AF</jats:styled-content>. Women were, on average, 63.4 years old, 7.8% were African American, and 3.6% were Hispanic. Increased<jats:styled-content style="fixed-case">BMI</jats:styled-content>(hazard ratio [<jats:styled-content style="fixed-case">HR</jats:styled-content>], 1.12 per 5‐kg/m<jats:sup>2</jats:sup>increase; 95% confidence interval [<jats:styled-content style="fixed-case">CI</jats:styled-content>], 1.10 to 1.14) and reduced physical activity (>9 vs. 0 metabolic equivalent task hours per week;<jats:styled-content style="fixed-case">HR</jats:styled-content>, 0.90; 95%<jats:styled-content style="fixed-case">CI</jats:styled-content>, 0.85 to 0.96) were independently associated with higher rates of<jats:styled-content style="fixed-case">AF</jats:styled-content>after multivariate adjustment. Higher levels of physical activity reduced the<jats:styled-content style="fixed-case">AF</jats:styled-content>risk conferred by obesity (interaction<jats:italic>P</jats:italic>=0.033).</jats:p></jats:sec><jats:sec xml:lang="en"><jats:title>Conclusions</jats:title><jats:p xml:lang="en">Greater physical activity is associated with lower rates of incident<jats:styled-content style="fixed-case">AF</jats:styled-content>and modifies the association between obesity and incident<jats:styled-content style="fixed-case">AF</jats:styled-content>.</jats:p></jats:sec>
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