Athletes are two and half times more likely than non-athletes to experience irregular heartbeats, studies suggest.
Researchers analysed 13 studies between 1990 and December 2020 which examined the health of athletes who took part in sports including cycling, running, swimming, Nordic skiing, orienteering, rowing, football, rugby and netball.
The studies included data on 70,478 participants.
Previous studies have shown that physical activity can improve cardiovascular health and is associated with reduced illness and deaths.
However the new research suggests there is a threshold beyond which exposure to increasing levels of exercise is linked to heart issues including atrial fibrillation – a condition that sees irregular heartbeats raise the risk of stroke, heart failure and other heart-related problems.
Researchers found the risk of atrial fibrillation was 2.46 times higher among athletes than non-athletes.
It also found that those who played football, rugby or netball appear to have the highest risk of atrial fibrillation compared with athletes taking part in endurance sports such as Nordic skiing, orienteering or rowing.
The study also analysed athletes and non-athletes who had cardiovascular diseases, such as type 2 diabetes and high blood pressure, but found no significant difference in risk.
The researchers found younger athletes, those aged under 55, had a much higher risk (3.6 times or 360%) of atrial fibrillation than older athletes.
Those aged 55 and older were 76% more likely to have the condition than non-athletes.
The study, which was published in the British Journal of Sports Medicine and has been peer-reviewed, was led by researchers from Canterbury Christ Church University.
There was limited data on female athletes, making it difficult to look at the relative risk of atrial fibrillation by gender.
The researchers said: “Athletes have a significantly greater likelihood of developing atrial fibrillation compared with non-athlete controls.
“Younger aged athletes have a greater relative risk of atrial fibrillation compared with older athletes, however, exercise dose parameters – including training and competition history, as well as potential gender differences for the risk of atrial fibrillation – requires future research.”
Trudie Lobban, founder and chief executive of Arrhythmia Alliance and AF Association, urged people to check their pulse rate as part of the campaigning group’s Know Your Pulse (KYP) campaign.
“Arrhythmias (heart rhythm disorders) affect people of all ages, young and old, whether they are fit or not,” she said.
“Regular exercise, as part of a healthy lifestyle, is important for reducing the risk of cardiovascular disease, including the arrhythmia atrial fibrillation (AF).
“However, as this research shows, intensive exercise over a long period – i.e., as seen with athletes – can increase the risk of atrial fibrillation. Therefore, it is so important that we all get to know the rhythm of our hearts, not just our heart rate.”
Joanne Whitmore, senior cardiac nurse at the British Heart Foundation, offered advice to those who want to exercise but also have underlying heart conditions.
“As a precaution, check with your GP before exercising if you have an underlying heart condition such as AF,” she said.
“If your GP is in agreement, aim for exercise to be moderate intensity, which means you are breathing faster than normal, but can still have a conversation. If you feel breathless, you should reduce the intensity. Make sure you warm up before and cool down after you exercise as heart rate can change faster in those with AF.”