Exercise protective against stroke, death in individuals with or without AF

Physical activity (PA) helps lower the risks of stroke and mortality, regardless of the presence of atrial fibrillation (AF), according to the Norwegian population-based Tromsø and HUNT studies.

Analysis of data from more than 87,000 participants showed that compared with being inactive, engaging in high levels of physical activity reduced the risk of stroke by 32 percent among participants with AF and by 21 percent among those without AF.

For the risk of all-cause death, a reduction of between 11 percent and 22 percent was observed with low-to-high physical activity levels vs inactivity in the total cohort, with similar risk reductions observed in participants with AF and those without AF (p=0.484 for interaction). 

The median follow-up was 13.5 years, during which 3,415 strokes and 7,833 deaths were documented in the total cohort.

The analysis included a total of 87,340 participants (mean age at baseline 50.9 years, 47.4 percent men), of which 6,539 had AF. Compared with those who had no AF, participants with AF were older, had a lower proportion of women, and were more likely to have comorbid conditions.

Most participants engaged in physical activity, with 37.5 percent, 23.5 percent, and 21.5 percent having low, moderate, and high activity levels, respectively. The remaining 17.5 percent were inactive. Participants reporting higher levels of physical activity tended to smoke less, have a lower BMI, have a lower prevalence of cardiovascular risk factors, and be at lower risk of stroke according to the CHA₂DS₂‐VA score.