• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Screening
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Gender Affects Exercise Tolerance in Atrial Fibrillation

Article

Menopause affects exercise tolerance in women.

©RaduBercan/Shutterstock.com

Although exercise has many cardiovascular benefits, including favorable vascular and metabolic changes, its impact on arrhythmias is less well understood. In particular, some studies have found a protective effect on atrial fibrillation (AF) whereas others have shown a possible increase in risk of AF with vigorous activity, which could result in electrical remodeling in the left atrium.

A recent meta-analysis presented at the American College of Cardiology Scientific Sessions 2015,1 included 12 prospective observational studies (N=372,682) and reported some gender differences in the impact of exercise on AF. In the men (mean age, 56 years), vigorous exercise increased the hazard for AF 1.7 times (95% CI, 1.4-2.05) whereas moderate exercise was associated with an approximate 10% lower incidence of AF (HR=0.81; 95% CI, 0.34-0.96).  In women (mean age, 61 years), both moderate- and high-intensity exercise lowered the incidence of AF to HR=0.76 (95% CI, 0.21-0.82) and HR=0.85 (95% CI, 0.43-0.94), respectively.

There may be a hormonal influence on the risk of developing AF. Results of another observational study of ≈18,000 middle-aged women, presented at the Heart Rhythm Scientific Sessions 2015,2 found that in women who underwent menopause before age 44 years, there was a 17% lower incidence of AF. However, there may be a high risk of confounding in this study related to medical comorbidities among participants and specific reasons for premature menopause.

Based on these data, clinicians can safely issue a prescription to male and female patients with AF to engage in moderate-intensity exercise. However, vigorous exercise should carry a warning. Although these results are observational in nature and therefore may be associative rather than causative, the large sample size and dramatic hazard ratios do provide some pause for high-intensity sports in those with AF.

References:

Related Videos
New Research Amplifies Impact of Social Determinants of Health on Cardiometabolic Measures Over Time
Where Should SGLT-2 Inhibitor Therapy Begin? Thoughts from Drs Mikhail Kosiborod and Neil Skolnik
Related Content
© 2024 MJH Life Sciences

All rights reserved.