Article Text
PDF
Abstract
Objectives Dedicated studies aimed at investigating the relationship between walking pace and arrhythmia are limited. This study assessed associations between self-reported and accelerometer measured walking pace and incident cardiac arrhythmias, overall and by subtype, and explored metabolic and inflammatory markers as possible mediators.
Methods Self-reported average walking pace was available for 420 925 UK Biobank participants, and accelerometer measured time spent walking at different paces was available for 81 956 participants. Outcomes were incident cardiac arrhythmias: all, atrial fibrillation (AF), other (including bradyarrhythmias and ventricular arrhythmias), bradyarrhythmias and ventricular arrhythmias. Cox proportional regression models were used to investigate the associations.
Results Compared with slow walking pace, average and brisk walking pace were associated with significantly lower risks of all cardiac arrhythmias (hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.62 to 0.68; HR 0.57, 95% CI 0.54 to 0.60), AF (HR 0.62, 95% CI 0.58 to 0.65; HR 0.54, 95% CI 0.50 to 0.57) and other arrhythmias (HR 0.69, 95% CI 0.64 to 0.73; HR 0.61, 95% CI 0.57 to 0.65). Overall, 36.0% of the association between walking pace and all arrhythmias was mediated via metabolic and inflammatory markers. The associations were stronger in women, in those aged <60 years, in those with a body mass index <30, in those who had hypertension and in those with ≥2 long term conditions.
Conclusions Average and brisk self-reported walking pace and time spent walking at moderate and brisk pace were associated with a decreased risk of cardiac arrhythmias, in part mediated via metabolic and inflammatory pathways. Our findings suggest brisk walking may be a safe and effective exercise to reduce arrhythmias, especially for higher risk groups.
- Arrhythmias, Cardiac
- Epidemiology
Data availability statement
Data are available upon reasonable request. Data analysed in this study was from the UK Biobank and is available upon application to UK Biobank https://www.ukbiobank.ac.uk.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request. Data analysed in this study was from the UK Biobank and is available upon application to UK Biobank https://www.ukbiobank.ac.uk.
Footnotes
Contributors PQ, FKH, CAC-M and JPP conceptualised the study. FKH, CAC-M and SGT were responsible for the data collection, data curation, and analysis and interpretation. PQ performed the data analysis, visualisation and wrote the initial manuscript draft. FKH, CAC-M, SGT and JPP revised the manuscript. All authors read and approved the final manuscript and JPP guaranted the contributions of all authors.
Funding UK Biobank was established by the Wellcome Trust Medical Research Council, Department of Health, Scottish government and the Northwest Regional Development Agency. It has also had funding from the Welsh assembly government and the British Heart Foundation. PQ receives financial support from the China Scholarship Council.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.