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Obesity,physical activity,and their interaction in incident atrial fibrillation in postmenopausal women
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نویسنده
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azarbal f. ,stefanick m.l. ,salmoirago-blotcher e. ,manson j.e. ,albert c.m. ,lamonte m.j. ,larson j.c. ,li w. ,martin l.w. ,nassir r. ,garcia l. ,assimes t.l. ,tharp k.m. ,hlatky m.a. ,perez m.v.
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منبع
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journal of the american heart association - 2014 - دوره : 3 - شماره : 4
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چکیده
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Background-atrial fibrillation (af) is the most common cardiac arrhythmia and is associated with increased risk of stroke and death. obesity is an independent risk factor for af,but modifiers of this risk are not well known. we studied the roles of obesity,physical activity,and their interaction in conferring risk of incident af. methods and results-the women's health initiative (whi) observational study was a prospective observational study of 93 676 postmenopausal women followed for an average of 11.5 years. incident af was identified using whi-ascertained hospitalization records and diagnostic codes from medicare claims. a multivariate cox's hazard regression model adjusted for demographic and clinical risk factors was used to evaluate the interaction between obesity and physical activity and its association with incident af. after exclusion of women with prevalent af,incomplete data,or underweight body mass index (bmi),9792 of the remaining 81 317 women developed af. women were,on average,63.4 years old,7.8% were african american,and 3.6% were hispanic. increased bmi (hazard ratio [hr],1.12 per 5-kg/m2 increase; 95% confidence interval [ci],1.10 to 1.14) and reduced physical activity (>9 vs. 0 metabolic equivalent task hours per week; hr,0.90; 95% ci,0.85 to 0.96) were independently associated with higher rates of af after multivariate adjustment. higher levels of physical activity reduced the af risk conferred by obesity (interaction p=0.033). conclusions-greater physical activity is associated with lower rates of incident af and modifies the association between obesity and incident af. © 2014 the authors.
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کلیدواژه
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Atrial fibrillation; Electrophysiology; Epidemiology; Exercise; Obesity
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آدرس
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division of cardiovascular medicine,department of medicine,stanford university school of medicine,stanford,ca, United States, department of medicine,stanford prevention research center,stanford university school of medicine,stanford,ca, United States, department of medicine,brown university school of medicine,providence,ri, United States, division of preventive medicine,brigham and women's hospital,harvard medical school,boston,ma, United States, division of preventive medicine,brigham and women's hospital,harvard medical school,boston,ma,united states,division of cardiology,department of medicine,brigham and women's hospital,harvard medical school,boston,ma, United States, department of social and prevention medicine,school of public health and health professions,university of buffalo,buffalo,ny, United States, data coordinating center,fred hutchinson cancer research center,seattle,wa, United States, division of preventive and behavioral medicine,university of massachusetts medical school,worcester,ma, United States, school of medicine and health sciences,george washington university,washington,dc, United States, department of biochemistry and molecular medicine,university of california davis,davis,ca, United States, department of public health sciences,university of california davis,davis,ca, United States, division of cardiovascular medicine,department of medicine,stanford university school of medicine,stanford,ca, United States, institutional research and assessment,loras college,dubuque,ia, United States, division of cardiovascular medicine,department of medicine,stanford university school of medicine,stanford,ca,united states,department of health research and policy,stanford university school of medicine,stanford,ca, United States, division of cardiovascular medicine,department of medicine,stanford university school of medicine,stanford,ca, United States
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Authors
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