• Light to moderate leisure-time activities including gardening, outside chores, golfing, dancing; walking distance and pace of walking; and moderate-intensity exercise were associated with significantly lower AF risk.
• In contrast to prior reports that vigorous exertion and exercise increase risk of AF in younger and middle-aged adults, these findings suggest that habitual light to moderate activities lower risk of AF in older adults, the group at highest risk for AF.

DALLAS, Aug. 5 – Light-to-moderate physical activity such as leisure-time activities and walking are linked with a significantly lower risk of developing atrial fibrillation (AF), researchers reported in a study in Circulation: Journal of the American Heart Association.

AF is an irregular and rapid heartbeat that can lead to palpitations, chronic fatigue, heart failure and stroke. It is the most common chronic heart rhythm disturbance in adults and is especially common after age 65.

Past studies of middle-aged and younger people have shown an increased risk for AF with vigorous exertion and endurance training. In this study of 5,446 adults (average age 73 years at baseline), researchers found high-intensity exercise was not associated with a higher or lower AF risk.

“In contrast, light-to-moderate leisure-time activities including gardening, outside chores, golfing, even dancing; walking distance and pace of walking; and moderate-intensity exercise were all associated with significantly lower risk,” said Dariush Mozaffarian, M.D., Dr.P.H., study lead author and a cardiologist at Brigham and Women’s Hospital, Harvard Medical School and Harvard School of Public Health. “The findings suggest that long-term benefits of habitual light-to-moderate physical activity in older adults outweigh any potential higher risks of AF associated with the acute activity or exercise.”

After adjusting for other risk factors, researchers found a 36 percent lower risk of developing AF when comparing the highest versus lowest levels of leisure-time activity. They found a 50 percent lower risk of developing AF when comparing the highest to lowest category of walking distance and pace.

Compared to a person having little or no leisure-time activity:
• Participants with light-to-moderate levels of leisure-time activity, for an average 20 to 30 minutes per day, had 22 percent to 25 percent lower risk of AF.
• Those with the higher levels had 36 percent lower risk.
Compared to those walking less than five blocks a week:
• Individuals walking five to 11 blocks had 22 percent lower risk of AF.
• Those walking 12 to 23 blocks had 24 percent lower risk.
• Those walking 24 to 59 blocks had 33 percent lower risk.
• Those walking 60 plus blocks a week had 44 percent lower incidence.

“This is the first prospective study to examine light-to-moderate physical activity and the development of AF,” Mozaffarian said. “The focus was on older adults, in whom most atrial fibrillation occurs: after age 65, almost one in five people will develop AF over 10 years.”

Other studies show that habitual light-to-moderate physical activity maintains the healthy elasticity of the heart and blood vessels, reduces fat mass in the body, and maintains muscle mass, he said. Through these and other effects, physical activity lowers resting heart rate and blood pressure, improves glucoses levels and lowers inflammation.

“Each of these are risk factors for AF,” Mozaffarian said. “Physical activity can also reduce the risk of heart attack and congestive heart failure. Older adults who aren’t currently active should talk to their doctors first. But most older adults should walk regularly and enjoy other leisure-time activities such as gardening, dancing, golfing or swimming. We aren’t talking about running marathons, or even running. Just enjoy regular walks to the park or around the neighborhood.

“These easily achievable lifestyle habits, including leisure-time activities and walking, should be further evaluated as potential preventive measures to reduce the incidence of AF in older adults,” Mozaffarian said. “These results provide additional strong reasons for clinicians and policymakers to focus on regular physical activity to maintain cardiovascular health in older adults.”

Co-authors are: Curt D. Furberg, M.D., Ph.D.; Bruce Psaty, M.D., Ph.D.; and David Siscovick, M.D., M.P.H.

Individual author disclosures can be found on the manuscript.

The National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke funded the study.

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NR08-1094 (Circ/Mozaffarian)