Adolescent Cardiorespiratory Fitness and the Trade-Off Between Atrial Fibrillation Risk and Cardiovascular Benefits: Evidence from a Nationwide Sibling-Controlled Cohort Study

Highlights

• High cardiorespiratory fitness in adolescence is associated with a small excess risk of atrial fibrillation (AF) during early adulthood.
• This AF risk is outweighed by a substantially larger reduction in non-AF cardiovascular disease (CVD) risk from middle age onward.
• Sibling-controlled analyses reveal that shared familial factors partly explain the observed associations, eliminating any early life cardiovascular disadvantage.
• Findings reinforce public health initiatives promoting improved adolescent fitness for long-term cardiovascular benefits.

Background