| 1. |
- Drca, Nikola, et al.
(författare)
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Atrial fibrillation is associated with different levels of physical activity levels at different ages in men
- 2014
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Ingår i: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 100:13, s. 1037-1042
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study examines the influence of physical activity at different ages and of different types, on the risk of developing atrial fibrillation (AF) in a large cohort of Swedish men. Methods Information about physical activity was obtained from 44 410 AF-free men, aged 45-79 years (mean age=60), who had completed a self-administered questionnaire at baseline in 1997. Participants reported retrospectively their time spent on leisure-time exercise and on walking or bicycling throughout their lifetime (at 15, 30 and 50 years of age, and at baseline (mean age=60)). Participants were followed-up in the Swedish National Inpatient Register for ascertainment of AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% CIs, adjusted for potential confounders. Results During a median follow-up of 12 years, 4568 cases of AF were diagnosed. We observed a RR of 1.19 (95% CI 1.05 to 1.36) of developing AF in men who at the age of 30 years had exercised for >5 h/week compared with <1 h/week. The risk was even higher (RR 1.49, 95% CI 1.14 to 1.95) among the men who exercised >5 h/week at age 30 and quit exercising later in life (<1 h/week at baseline). Walking/bicycling at baseline was inversely associated with risk of AF (RR 0.87, 95% CI 0.77 to 0.97 for >1 h/day vs almost never) and the association was similar after excluding men with previous coronary heart disease or heart failure at baseline (corresponding RR 0.88, 95% CI 0.77 to 0.998). Conclusions Leisure-time exercise at younger age is associated with an increased risk of AF, whereas walking/bicycling at older age is associated with a decreased risk.
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| 2. |
- Drca, Nikola, et al.
(författare)
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Elite female endurance athletes are at increased risk of atrial fibrillation compared to the general population : a matched cohort study.
- 2023
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Ingår i: British Journal of Sports Medicine. - 0306-3674 .- 1473-0480. ; 57:18, s. 1175-1179
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Previous studies have found that endurance sport activity is associated with an increased risk of atrial fibrillation (AF) in men. However, it remains unclear whether endurance sports also influence the risk of AF in women. We aimed to examine whether participation in endurance sports may affect the risk of AF in female athletes.METHODS: We conducted a retrospective matched cohort study of top Swedish female endurance athletes (n=228) and reference individuals (n=1368) from the general population using the Swedish Total Population Register individually matched with a 6:1 ratio of female athletes. The athlete cohort was created by combining all Swedish women who ran the Stockholm Marathon faster than 3 hours 15 min in any of the races between 1979 and 1991, all women competing in the Swedish athletic national championships in the 10 000 metre race, and the top-ranked Swedish cyclists during the same period. We used the National Patient Register to determine whether the participants were diagnosed with AF.RESULTS: Mean age at the start of follow-up was 32 (SD±8.5) years. During follow-up (mean 28.8 years; SD±4.4), 33 cases of AF were diagnosed, including 10 (4.4%) among athletes and 23 (1.7%) among references. The HR for female athletes compared with the reference population was 2.56 (95% CI 1.22 to 5.37) in the univariable model and 3.67 (95% CI 1.71 to 7.87) after adjustment for hypertension.CONCLUSION: Elite female endurance athletes are at increased risk of AF than the general population.
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| 3. |
- Drca, Nikola, et al.
(författare)
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Occupational physical activity is associated with risk of atrial fibrillation in both men and women : a population-based cohort study
- 2021
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Ingår i: Acta Cardiologica. - : Taylor & Francis. - 0001-5385 .- 1784-973X .- 0373-7934. ; 76:7, s. 712-717
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Previous studies have found that excessive sport activities are associated with an increased risk of atrial fibrillation (AF). Whether occupational physical activity (OPA) increases the risk for AF is not well studied. We aimed to examine whether OPA influences the risk of AF.Methods: 80,922 men and women, free from AF, completed in 1997 a questionnaire about their OPA at that time (baseline), and also retrospectively in 1997 their OPA at the age of 30 and 50 years. Participants were categorised into three groups (low, medium and high) based on OPA load. Participants were followed-up in the Swedish National Patient Register for ascertainment of AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders.Results: 11,614 cases of AF were diagnosed during follow-up time of up to 17 years. We observed an increased risk of AF in relation to increased load of OPA regardless of age. Compared with men who reported a low load of OPA, the multivariable RR (95% CI) for men with a high load was 1.10 (1.03-1.17) at 30 years, 1.11 (1.04-1.17) at 50 years and 1.19 (1.10-1.29) at baseline. The results for women were similar with multivariable RR of 1.16 (1.06-1.27) at 30 years, 1.14 (1.05-1.24) at 50 years and 1.11 (0.99-1.24) at baseline.Conclusion: These findings suggest that high load of OPA previous in life may play a role in increasing the risk for AF in both men and women.
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| 4. |
- Drca, Nikola, et al.
(författare)
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Physical activity is associated with a reduced risk of atrial fibrillation in middle-aged and elderly women
- 2015
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 101:20, s. 1627-1630
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Previous studies have found that regular participation in intense physical activity increases the risk of developing atrial fibrillation (AF) in men, but it remains unclear how physical activity influences the risk of AF in women. We aimed to examine whether physical activity of different types and at different ages influences the development of AF in women.METHODS: In the population-based Swedish Mammography Cohort, information about physical activity was obtained from 36 513 AF-free women (49-83 years old, median age 60 years) who had completed a questionnaire at study entry (1997). Participants reported their time spent on leisure-time exercise and on walking or bicycling throughout their lifetime (at study entry, and at 30 and 50 years of age). We used the Swedish National Inpatient Register (IPR) to determine whether the participants were diagnosed with AF. Cox proportional hazards regression models were used to estimate relative risks (RR) with 95% CI, adjusted for potential confounders.RESULTS: During a median follow-up of 12 years (10th percentile 7.5 years, 90th percentile 12.0 years), 2915 cases of AF were diagnosed. The risk of AF decreased with increasing levels of leisure-time exercise at study entry (RR 0.85, 95% CI 0.75 to 0.95 for ≥4 h/week vs <1 h/week) and walking/bicycling (RR 0.81, 95% CI 0.72 to 0.92, for ≥40 min/day vs almost never).CONCLUSIONS: Physical activity is associated with a reduced risk of AF in women. Moderate amount of physical activity was sufficient to significantly reduce AF risk.
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| 5. |
- Larsson, Susanna C., et al.
(författare)
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Alcohol Consumption and Risk of Atrial Fibrillation A Prospective Study and Dose-Response Meta-Analysis
- 2014
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Ingår i: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 64:3, s. 282-289
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Although high alcohol consumption has been associated with increased risk of atrial fibrillation (AF), the role of light to moderate drinking remains unclear. OBJECTIVES The study sought to investigate the association between alcohol consumption and AF risk in a prospective study of Swedish men and women and to conduct a meta-analysis of prospective studies to summarize available evidence. METHODS We followed 79,019 men and women who, at baseline, were free from AF and had completed a questionnaire about alcohol consumption and other risk factors for chronic diseases. Incident AF cases were ascertained by linkage to the Swedish Inpatient Register. For the meta-analysis, studies were identified by searching PubMed through January 10, 2014, and by reviewing references of pertinent publications. Study-specific relative risks (RRs) were combined using a random effects model. RESULTS Over 859,420 person-years of follow-up (1998 to 2009), 7,245 incident AF cases were identified in our own cohort study. The association between alcohol consumption and AF did not differ by sex (p for interaction 0.74). Compared with current drinkers of < 1 drink/week (12 g alcohol/drink), the multivariable RRs of AF were 1.01 (95% confidence interval [CI]: 0.94 to 1.09) for 1 to 6 drinks/week, 1.07 (95% CI: 0.98 to 1.17) for 7 to 14 drinks/week, 1.14 (95% CI: 1.01 to 1.28) for 15 to 21 drinks/week, and 1.39 (95% CI: 1.22 to 1.58) for > 21 drinks/week. Results were similar after excluding binge drinkers. In a meta-analysis of 7 prospective studies, including 12,554 AF cases, the RRs were 1.08 (95% CI: 1.06 to 1.10) for 1 drink/day, 1.17 (95% CI: 1.13 to 1.21) for 2 drinks/day, 1.26 (95% CI: 1.19 to 1.33) for 3 drinks/day, 1.36 (95% CI: 1.27 to 1.46) for 4 drinks/day, and 1.47 (95% CI: 1.34 to 1.61) for 5 drinks/day, compared with nondrinkers. CONCLUSIONS These findings indicate that alcohol consumption, even at moderate intakes, is a risk factor for atrial fibrillation. (C) 2014 by the American College of Cardiology Foundation.
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| 6. |
- Larsson, Susanna C, et al.
(författare)
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Chocolate consumption and risk of atrial fibrillation : Two cohort studies and a meta-analysis
- 2018
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 195, s. 86-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Chocolate consumption has been inconsistently associated with risk of atrial fibrillation (AF). We investigated the association between chocolate consumption and risk of AF in Swedish adults from two cohort studies and conducted a meta-analysis to summarize available evidence from cohort studies on this topic.METHODS: Our study population comprised 40,009 men from the Cohort of Swedish Men and 32,486 women from the Swedish Mammography Cohort. Incident AF cases were ascertained through linkage with the Swedish National Patient Register. Published cohort studies of chocolate consumption in relation to risk of AF were identified by a PubMed search through September 14, 2017.RESULTS: During a mean follow-up of 14.6 years, AF was diagnosed in 9978 Swedish men and women. Compared with non-consumers, the multivariable hazard ratio of AF for those in the highest category of chocolate consumption (≥3-4 servings/week) was 0.96 (95% CI 0.88-1.04). In a random-effects meta-analysis of 5 cohort studies, including 180,454 participants and 16,356 AF cases, the hazard ratios of AF were 0.97 (95% CI 0.94-1.01) per 2 servings/week increase in chocolate consumption and 0.96 (95% CI 0.90-1.03) for the highest versus lowest category of chocolate consumption.CONCLUSION: Available data provide no evidence of an association of chocolate consumption with risk of AF.
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| 7. |
- Larsson, Susanna C., et al.
(författare)
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Coffee consumption is not associated with increased risk of atrial fibrillation : results from two prospective cohorts and a meta-analysis
- 2015
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Whether coffee consumption affects the risk of developing atrial fibrillation (AF) remains unclear. We sought to investigate the association between coffee consumption and incidence of AF in two prospective cohorts, and to summarize available evidence using a meta-analysis.METHODS: Our study population comprised 41,881 men in the Cohort of Swedish Men and 34,594 women in the Swedish Mammography Cohort who had provided information on coffee consumption in 1997 and were followed up for 12 years. Incident cases of AF were ascertained by linkage with the Swedish Hospital Discharge Register. For the meta-analysis, prospective studies were identified by searching PubMed and Embase through 22 July 2015, and by reviewing the reference lists of retrieved articles. Study-specific relative risks were combined using a random effects model.RESULTS: We ascertained 4,311 and 2,730 incident AF cases in men and women, respectively, in the two cohorts. Coffee consumption was not associated with AF incidence in these cohort studies. The lack of association was confirmed in a meta-analysis, including six cohort studies with a total of 10,406 cases of AF diagnosed among 248,910 individuals. The overall relative risk (95% confidence interval) of AF was 0.96 (0.84-1.08) for the highest versus lowest category of coffee consumption, and 0.99 (0.94-1.03) per 2 cups/day increment of coffee consumption.CONCLUSIONS: We found no evidence that coffee consumption is associated with increased risk of AF.
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| 8. |
- Larsson, Susanna C., et al.
(författare)
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Combined impact of healthy lifestyle factors on risk of atrial fibrillation : Prospective study in men and women.
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 203, s. 46-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The combined impact of multiple lifestyle factors on risk of atrial fibrillation (AF) remains unclear. We investigated the joint association of four modifiable lifestyle factors on incidence of AF in a prospective study of men and women.METHODS: The study cohort comprised 39 300 men in the Cohort of Swedish Men and 33 090 women in the Swedish Mammography Cohort who were 45-83 years of age and free from atrial fibrillation at baseline. Healthy lifestyle was defined as body mass index <25 kg/m(2), regular exercise for ≥ 20 min/day, no or light-to-moderate alcohol consumption (≤ 2 drinks/day for men and ≤ 1 drink/day for women), and not smoking. Incident AF cases were identified through linkage with the Swedish National Inpatient Register.RESULTS: During a mean follow-up of 10.9 years, AF occurred in 4028 men and 2539 women. Compared with men and women with no healthy lifestyle factors, the multivariable relative risks (95% confidence interval) of AF were 0.83 (0.65-1.07) for one, 0.74 (0.58-0.94) for two, 0.62 (0.49-0.79) for three, and 0.50 (0.39-0.64) for four healthy lifestyle factors (P for trend <0.0001). The inverse association was similar in men and women.CONCLUSIONS: Four healthy lifestyle factors combined were associated with a halving of the risk of AF.
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| 9. |
- Larsson, Susanna C., et al.
(författare)
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Incidence of atrial fibrillation in relation to birth weight and preterm birth
- 2015
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 178, s. 149-152
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hypertension, type 2 diabetes and other cardiovascular diseases, all risk factors for atrial fibrillation, are associated with birth weight. It remains unclear, however, whether risk of atrial fibrillation is also associated with birth weight. We investigated the associations of birth weight and preterm birth (i.e., born more than one month before term) with risk of atrial fibrillation (AF).METHODS: The study population comprised 29551 men and 23454 women who were free from AF at baseline. Information on birth weight, preterm birth, and risk factors for AF was obtained from a questionnaire. Incident AF cases were ascertained by linkage to the Swedish Inpatient Register.RESULTS: During 12years of follow-up, AF developed in 2711 men and 1491 women. High birth weight (≥5000g) was associated with an increased risk of AF after adjustment for age and other risk factors for AF, but the association did not persist after further adjustment for adult height. In men but not in women, low birth weight was associated with an increased risk of AF. Compared with men weighing 2500-3999g at birth, the multivariable RR was 1.86 (95% CI, 1.15 to 3.00) for those weighing <1500g. This association was stronger in men who were born full-term (RR 2.53; 95% CI, 1.35 to 4.73).CONCLUSIONS: Both high birth weight and low birth weight (in men), in particular in men born full-term, were associated with an increased risk of AF. The association with high birth weight appeared to be mediated through adult height.
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| 10. |
- Larsson, Susanna C., et al.
(författare)
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Nut consumption and incidence of seven cardiovascular diseases
- 2018
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Ingår i: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 104:19, s. 1615-1620
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Tidskriftsartikel (refereegranskat)abstract
- Background Nut consumption has been found to be inversely associated with cardiovascular disease mortality, but the association between nut consumption and incidence of specific cardiovascular diseases is unclear. We examined the association between nut consumption and incidence of seven cardiovascular diseases. Methods This prospective study included 61 364 Swedish adults who had completed a Food Frequency Questionnaire and were followed up for 17 years through linkage with the Swedish National Patient and Death Registers. Results Nut consumption was inversely associated with risk of myocardial infarction, heart failure, atrial fibrillation and abdominal aortic aneurysm in the age-adjusted and sex-adjusted analysis. However, adjustment for multiple risk factors attenuated these associations and only a linear, dose-response, association with atrial fibrillation (p(trend)=0.004) and a non-linear association (p(non-linearity)=0.003) with heart failure remained. Compared with no consumption of nuts, the multivariable HRs (95% CI) of atrial fibrillation across categories of nut consumption were 0.97 (0.93 to 1.02) for 1-3 times/month, 0.88 (0.79 to 0.99) for 1-2 times/week and 0.82 (0.68 to 0.99) for 3times/week. For heart failure, the corresponding HRs (95% CI) were 0.87 (0.80 to 0.94), 0.80 (0.67 to 0.97) and 0.98 (0.76 to 1.27). Nut consumption was not associated with risk of aortic valve stenosis, ischaemic stroke or intracerebral haemorrhage. Conclusions These findings suggest that nut consumption or factors associated with this nutritional behaviour may play a role in reducing the risk of atrial fibrillation and possibly heart failure. Trial registration number NCT01127711 and NCT01127698; Results.
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