Risk of atrial fibrillation and stroke among older men exposed to prolonged endurance sport practice: a 10-year follow-up. The Birkebeiner Ageing Study and the Tromsø Study
,
Bente Morseth,
Tom Wilsgaard,
Maja-Lisa Løchen,
Anette Hylen Ranhoff,
Arnljot Tveit,
Marius Myrstad,
Jon Magne Letnes,
Bjarne Martens Nes,
Dag S Thelle,
Turid Apelland,
Kim Arne Heitmann,
Kristoffer Robin Johansen,
Eivind Sørensen,
Bjarne M Nes,
Silvana Bucher Sandbakk,
Jan Pål Loennechen,
Kristine Folkenborg,
Kristin Espolin Johnson,
Vegard Malmo,
Andreas Berg Sellevold,
Rune Byrkjeland,
Steve Enger,
Hilde Larhammer,
Sophia Onarheim,
Vigdis Bache-Semb
Affiliations
Bente Morseth
School of Sport Sciences, UiT The Arctic University of Norway, Tromso, Norway
Tom Wilsgaard
Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
Maja-Lisa Løchen
Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
Anette Hylen Ranhoff
Department of Clinical Science, University of Bergen, Bergen, Norway
Arnljot Tveit
Department of Medical Research, Bærum Hospital Vestre Viken Trust, Gjettum, Norway
Marius Myrstad
Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, N-1346 Gjettum, Norway
Jon Magne Letnes
Bjarne Martens Nes
Dag S Thelle
Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
Turid Apelland
Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, N-1346 Gjettum, Norway
Kim Arne Heitmann
School of Sport Sciences, UiT The Arctic University of Norway, Tromso, Norway
Kristoffer Robin Johansen
School of Sport Sciences, UiT The Arctic University of Norway, Tromso, Norway
Eivind Sørensen
Department of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway
Bjarne M Nes
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
Silvana Bucher Sandbakk
Department for Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
Aims Endurance sport practice is associated with a high prevalence of atrial fibrillation (AF), which increases the risk of stroke in the general population. However, stroke risk in endurance athletes with AF is sparsely investigated. Most studies have been limited by design and are largely restricted to younger and middle-aged populations. Thus, we aimed to investigate AF and stroke risk in older athletes exposed to prolonged endurance training.Method During a 10-year period, 505 male athletes aged ≥65 years frequently participating in a long-distance ski race were compared with 1867 men of the same age from the general population. The main exposure was endurance sport practice with self-reported AF and stroke as outcomes. Stroke risk was further examined by joint modelling of AF and endurance practice. Statistical analysis was conducted with a modified Poisson model.Results Athletes (median age: 68, range: 65–90) participated in a long-distance ski race over a median of 14 years (range: 1–53). Prevalence (28.5% vs 17.8%) and adjusted risk of AF (risk ratio (RR): 1.88, 95% CI: 1.49 to 2.37) were higher in athletes compared with non-athletes, whereas the prevalence (5.4% vs 9.7%) and risk of stroke were lower (RR: 0.60, 95% CI: 0.37 to 0.95). Compared with athletes without AF, risk of stroke was twofold in athletes (RR: 2.38, 95% CI: 1.08 to 5.24) and nearly fourfold in non-athletes (RR: 3.87, 95% CI: 1.98 to 7.57) with AF.Conclusion Although older male endurance athletes experienced an increased risk of AF, the long-term risk of stroke was substantially reduced compared with non-athletes.
