A faster self-reported and accelerometer-measured walking pace may be associated with a lower risk of developing cardiac arrhythmias, including atrial fibrillation, according to a prospective cohort study.
In the study, investigators analyzed data from 420,925 participants in the UK Biobank. Compared with individuals reporting a slow walking pace, those with an average pace had a 35% reduced risk of all arrhythmias (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.62–0.68), whereas brisk walkers had a 43% lower risk (HR = 0.57, 95% CI = 0.54–0.60). Similar associations were found for atrial fibrillation (AF) (HR = 0.62 and 0.54, respectively) and for other arrhythmias, including bradyarrhythmias and ventricular arrhythmias (HR = 0.69 and 0.61, respectively).
“These new findings reinforce the promotion of faster walking pace in PA recommendations that walking at a brisk pace may have a role in secondary as well as primary prevention of cardiac arrhythmias and provide evidence of higher risk groups to target,” said lead study author Pei Qin, PhD, of the University of Glasgow, and colleagues.
A subsample of 80,773 participants with accelerometer data provided further support. Time spent walking at a brisk pace was associated with a lower risk of arrhythmias, with those in the highest quartile showing an HR of 0.82 (95% CI = 0.74–0.91) compared with the lowest quartile. No statistically significant associations were found for time spent walking at a slow pace.
Over a median follow-up of 13.7 years, 36,574 participants developed arrhythmias, including 23,526 with AF, 19,093 with other arrhythmias, 5,678 with bradyarrhythmias, and 2,168 with ventricular arrhythmias. The incidence rates per 10,000 person-years were 65.9 for all arrhythmias, 41.9 for AF, 33.9 for other arrhythmias, 10.0 for bradyarrhythmias, and 3.7 for ventricular arrhythmias.
Mediation analysis revealed that metabolic and inflammatory markers—including body mass index (BMI), systolic blood pressure, total cholesterol, HbA1c, and C-reactive protein—jointly accounted for 36.0% (95% CI = 32.7%–40.1%) of the association between slow walking pace and arrhythmia risk. BMI alone explained 32.8% of the mediation effect.
Stratified analysis indicated that associations were stronger in women, individuals younger than 60 years, those with a BMI below 30, and participants with at least two long-term conditions, particularly hypertension.
The investigators employed Cox proportional hazard models adjusted for multiple covariates, including age, sex, ethnicity, socioeconomic status, diet, sleep duration, smoking, alcohol use, sedentary behavior, and total physical activity. The accelerometer subgroup was selected via constrained random sampling and had a 45% response rate
Limitations included potential selection bias, healthy volunteer bias, as well as reliance on self-reported pace and derived accelerometer data. The cohort was predominantly White British, which may affect generalizability.
This was one of the first large-scale cohort studies to examine accelerometer-derived walking pace in relation to arrhythmia incidence while also quantifying the mediating role of metabolic and inflammatory pathways.
The authors reported no conflicts of interest.
Source: Heart
