How fitness influences Afib and stroke risk

One of the most dangerous outcomes of atrial fibrillation (AFib) is stroke. People with this heart rhythm disorder have a stroke risk that’s five times higher than that of their peers. In fact, AFib is responsible for 1 out of every 7 strokes.

That’s reason enough to avoid becoming one of the more than 40 million people worldwide who have AFib. But how exactly can you dodge this debilitating condition?

The steps that help prevent AFib are similar to those you would take for overall heart health:

• Manage high blood pressure, high cholesterol and diabetes.
• Don’t smoke or use tobacco.
• Don’t drink alcohol.
• Avoid salt and saturated fat.
• Sleep 7 to 9 hours a night.
• Maintain a healthy weight.
• Reduce and manage stress.
• Get at least 30 minutes of exercise most days.

But let’s talk a bit more about that last recommendation — and how you can reduce your risk for Afib with a lower level of fitness than you might think…

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Fitness linked with lower AFib, stroke risk

As we’ve noted in an earlier issue, the role of exercise has been a contentious point when it comes to AFib prevention. While some studies have shown that exercise can help reduce or prevent AFib, other research has identified exercise as one of the triggers in AFib.

So it’s understandable that investigators continue to explore this link…

One such study, presented at ESC Congress 2023, examined whether fitness was related to the odds of developing AFib. It included 15,450 people around the age of 55 without atrial fibrillation. A little more than half were men and they all underwent treadmill testing between 2003 and 2012.

Their fitness levels were calculated by the rate of energy expenditure they achieved on the treadmill, expressed in metabolic equivalents (METs). They were then followed for new-onset AFib, stroke, myocardial infarction and death.

The researchers analyzed the connections between fitness and AFib, stroke and major adverse cardiovascular events (MACE), a composite of stroke, myocardial infarction and death. During a median of roughly 11 years, 3.3 percent of the participants developed AFib.

According to the results, each one MET increase on the treadmill test reduced risk of:

• AFib by 8 percent;
• stroke by 12 percent;
• and MACE by 14 percent.

In other words, the more fit the participant was, the lower their risk of AFib, stroke and MACE.

The study divided participants into three fitness levels and measured their probability of remaining AFib-free over a five-year period, and the news was good:

• 97.1 percent for the low fitness level group (less than 8.57 METs),;
• 98.4 percent for the medium group (8.57 to 10.72 METs);
• and 98.4 percent for the high fitness group (more than 10.72 METs).

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Safely increase your fitness level

This study seems to lean heavily that keeping fit may help prevent atrial fibrillation and stroke, according to the lead author. And it’s particularly exciting that even a low level of fitness will do the trick.

If you don’t have a regular fitness routine, start small. Try going for a 5- or 10-minute walk every day and increasing the time by one or two minutes each week until you hit a total of 3.5 hours. Brisk walking and walking up and down stairs can measure in at 3 to 6 METs.

For activities that can take your METs up a little more, The American Council on Exercise lists several, along with corresponding METs scores, including housework, jumping rope, hiking, bicycling and yoga.

But if you already have AFib or are at risk of developing AFib, you’ll want to speak with your doctor before ramping up your exercise program.

Something like yoga might be a good starter. In a study including people with intermittent AFib, the practice lowered blood pressure and heart rate and raised their quality of life.

Finally, stop exercising immediately if you experience pain, extreme shortness of breath or exhaustion. Your doctor may need to check your heart function before you can resume your workouts.

Sources:

Keep fit to avoid heart rhythm disorder and stroke — ScienceDaily

Atrial Fibrillation — Centers for Disease Control and Prevention

Atrial fibrillation — Mayo Clinic