Even light activity may lower risk of stroke and death in people with atrial fibrillation

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by American Heart Association

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Being physically active was linked to a lower risk of stroke and death for adults with atrial fibrillation, or AFib, according to new, independent research published today in the Journal of the American Heart Association.

"In general, people with AFib appear to be less active than the general population," said lead study author Kristoffer Johansen, Ph.D., a researcher at the School of Sport Sciences, Faculty of Health Sciences at UiT The Arctic University of Norway, Tromsø. "The results from our study indicate that physical activity was associated with a reduced risk of stroke and death in individuals with and without atrial fibrillation. So, regular physical activity is important for all and could be an important preventive strategy for people with AFib."

AFib is a quivering or irregular heartbeat that occurs in the heart's upper chambers, known as the atria. According to the American Heart Association, it can lead to blood clots, stroke and other heart-related conditions. The prevalence of AFib in the U.S. was estimated at 10.55 million, equivalent to 4.48% of the adult U.S. population, according to data reported in the American Heart Association's 2026 Heart Disease and Stroke Statistics.

The American Heart Association recommends that all adults spend less time sitting and get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. In addition, adults should participate in moderate muscle-strengthening activity at least twice a week.

The study tracked more than 87,000 adults in Norway for about 15 years, capturing information about AFib, stroke and death from national health registries.

What did the analysis find?

  • Compared to adults who were inactive, adults with a low, moderate or high level of physical activity had a 9%, 19% and 18% lower risk of stroke, respectively.
  • Having a low, moderate or high level of physical activity was associated with an 11%, 18% and 22% lower risk of death from any cause, respectively.
  • These benefits were similar regardless of whether a person had AFib. This suggests that having AFib does not change the relationship between physical activity and stroke.
  • For people with AFib, staying active was tied to living an average of 0.5 to 1.2 years longer compared with those who were inactive.

Previous research has suggested that people with AFib derive health benefits from regular physical activity. However, results have been somewhat inconclusive regarding the association between physical activity and stroke, Johansen said. This study suggests a positive impact of physical activity for people with AFib on both stroke risk and longevity.

"I hope our results will increase awareness among clinicians and people with AFib about the benefits of even low levels of physical activity," Johansen said. "Real health benefits can happen no matter when a person starts getting active, and even a little exercise is better than nothing."

Mina Chung, M.D., FAHA, co-chair of a 2023 joint guideline for diagnosis and management of atrial fibrillation from the American Heart Association and other organizations, said this study "adds important evidence linking physical activity with lower risks of stroke and death in people with and without AFib."

"It's important to remember that physical activity may also reflect overall health. Still, the results motivate patients to be as active as they can—even lower levels of activity were associated with benefit, while moderate to high levels were linked to greater benefit," added Chung, who is also a professor of medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and a cardiologist in the department of cardiovascular medicine, the section of cardiac electrophysiology & pacing within the Heart, Vascular & Thoracic Institute and the Department of Heart, Blood & Kidney Research at the Cleveland Clinic Research and the Cleveland Clinic.

What are the study details, background, design and limitations?

  • The study included health information for 87,340 participants from two large Norwegian health studies: the HUNT Study (including participants from the third and fourth surveys conducted in 2006–08 and 2017–19) and the Tromsø Study (including participants from the sixth and seventh surveys conducted in 2007–08 and 2015–16). Participants' average age was about 51 years at the time of enrollment in the studies. About 47% were men, and more than 6,500 participants had AFib.
  • Researchers divided people into four groups based on the reported level of regular physical activity, ranging from inactive to highly active. They specifically assessed participants' frequency of physical activity, ranging from never to almost every day; the duration of exercise, ranging from less than 15 minutes to more than one hour; and the intensity of exercise, ranging from "I take it easy without breaking into a sweat or losing my breath" to "I push myself to near-exhaustion."
  • The study used a multiple-records approach, meaning that if someone developed AFib during the follow-up, they were reclassified to the AFib group to ensure that the results for the AFib group were more accurate.
  • Limitations: Instead of randomly assigning people to a specific treatment or control group in a lab, individuals reporting different physical activity levels at the start of the study were followed over time. The consequence of this nonrandomized participant grouping is that other unmeasured or imprecisely measured factors may have influenced the relationship between physical activity and stroke or death. For example, more active individuals tend to live a healthier lifestyle in general. Therefore, despite statistical correction for several factors, the authors cannot exclude the possibility that other factors could have partially explained why physically active individuals had a lower risk of stroke and death. Also, people in the study reported their own activity levels, meaning they might have said they exercised more than they really did.

Johansen said similar results would be expected if this analysis were conducted among adults in the U.S.

Publication details

www.ahajournals.org/doi/10.1161/JAHA.126.048812

Journal information: Journal of the American Heart Association

Key medical concepts

Atrial FibrillationActivities, PhysicalStrokeAll-Cause Mortality

Clinical categories

CardiologyFitness & Physical activityHealthy livingPreventive medicineCommon illnesses & Prevention Provided by American Heart Association Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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