Arrhythmias & electrophysiology
Adolescent Cardiorespiratory Fitness and the Trade-Off Between Atrial Fibrillation Risk and Cardiovascular Benefits: A Nationwide Sibling-Controlled Cohort Study
Authors' conclusion
High adolescent cardiorespiratory fitness is associated with a small excess in AF risk during early adulthood that is outweighed by larger reductions in non-AF CVD after controlling for familial confounders.
Study context
- Population
- Swedish men at mandatory military conscription examinations 1972–1995 with cardiorespiratory fitness testingmen, mean age 18.3 years
- Participants
- 1,124,049 men
- Exposure
- Highest vs lowest decile of adolescent cardiorespiratory fitness
- Outcome
- AF and non-AF CVD (eg, stroke and ischemic heart disease), composite of diagnosis or death in national registers
- Follow-up
- Until December 31, 2023
Methodological detailsnationwide, sibling-controlled
- Nationwide
- Sibling-controlled
Main finding
As reported in the abstract
Non-AF cardiovascular disease (CVD) RD by age 35
−0.11%
95% CI −0.21% to −0.01%
Atrial fibrillation (AF) RD by age 35
0.06%
95% CI −0.01% to 0.12%
Non-AF CVD RD by age 65
−3.91%
95% CI −5.40% to −2.42%
AF RD by age 65
2.30%
95% CI 1.15% to 3.45%
Observational data: associations, not effects.
Further findings
First events, whole cohort · median age 54.8 (AF) and 54.4 (non-AF CVD) years
- First AF event
- 45 179 (4.0%)
- First non-AF CVD event
- 96 404 (8.6%)
Population-wide analysis (measured confounders)
- Highest vs lowest decile: small excess in AF exceeded reduction in non-AF CVD in early adulthood; reduction in non-AF CVD larger from 45 years of age onwards
Original publication
Summarised from the published abstract; every number is checked against it