Exercise and AFib
Dr. Peter Kokkinos serves as the Director, CRC Human Performance Research and Lifestyle Interventions for Veterans (LIVe) at the Washington DC VA Medical Center.
Risk of AFib Plunges with Cardio Fitness in Veterans with Hypertension or Diabetes
In case you needed another good reason to add exercise to your to-do list, research presented recently at the American Society of Hypertension’s annual meeting shows that cardiorespiratory fitness is associated with a lower risk of atrial fibrillation (AFib) in middle-aged men with diabetes or hypertension. Atrial fibrillation is a fast, irregular heart rhythm involving the upper heart chambers that can lead to stroke or heart failure.
According to Washington DC Veterans Affairs Medical Center’s Exercise Physiologist, Dr. Peter Kokkinos, the study’s results are significant. He, along with the medical center's Chief of Staff Dr. Charles Faselis and team members studied more than 4,000 Veterans and found that the AFib risk dropped by 58 percent in Veterans classified as “moderately fit and by 74 percent in those considered “highly fit. In fact, they found a 29 percent lower risk of AFib for every one-unit increase in peak metabolic equivalent of tasks (MET). To state it differently, for every 100 Veterans who developed AFib in the Least-fit category, only 70 in the Low-fit, 42 in the Moderate-fit and 26 in the High-fit developed AFib.
Note that even a little exercise was beneficial. Veterans considered to be "low fit" had a 30 percent lower AFib risk than their least-fit peers.
"This is very good news. These fitness levels are easily achievable through moderate daily exercise and physical activity.” Dr. Kokkinos recommends 30 minutes of a brisk walk most days of the week.
About the study:
Dr. Kokkinos and his team sought to examine a possible association between fitness and AFib risk in those with hypertension and/or diabetes mainly because little is known about this high-risk group.
The researchers identified a cohort of 4065 patients (mean age of 59 years) with these conditions but with normal sinus rhythm. All underwent an exercise tolerance test and were then divided into the following four groups, after being stratified by age:
- High-fit: 9 METs achieved (n=813)
- Moderate-fit: 7.8 METs (n=1044)
- Low-fit: 6.5 METs (n=1091)
- Least-fit: 5.0 METs (n=1117)
MET is a measurement of the amount of work or exercise one performs on a given time. In general: one MET stands for the amount of oxygen (and the number of calories) one needs at rest. "I'd say most daily activities are between 3-5 METs," explained Kokkinos.
"A fitness level of 6.5 METs (low-fit category) is achieved by a brisk walk two to three times per week, 30-40 minutes per session. The fitness level of about 8 METs (moderate-fit) is achieved by brisk walks three to four times weekly and the high-fit by walking four to five times per week.”
To put it in prospective, a professional Olympic athlete is probably at a MET level of 25. “That's not what we should be aiming for here. A distinction must be made between peak performance and health. It takes a lot of effort to be an athlete and relatively little work to be healthy.
Moderation is the key,” Kokkinos said.
