# The WHI Strong and Healthy SilenT Atrial fibrillation Recording study (WHISH STAR)

> **NIH NIH R01** · STANFORD UNIVERSITY · 2021 · $597,195

## Abstract

PROJECT SUMMARY/ABSTRACT
Atrial fibrillation (AF) is the most common arrhythmia in older women and results in a higher risk of stroke,
death and other comorbidities. Current treatments for AF are limited and novel preventive strategies are
needed. The effects of physical activity on AF are controversial. We and others have reported reduced rates
of AF associated with physical activity, but these studies are based on retrospective observational data. There
remains concern that patients at high risk for AF will have worse rates of AF with exercise. Since many older
patients are found to have asymptomatic AF, there is also concern that physical activity will result in silent AF
that is not detected with standard clinical care. Our long term goal is to reduce rates of AF with safe and
appropriate lifestyle recommendations. The WHI Strong & Healthy (WHISH) trial is an NIH-funded study where
women will be randomized to receive physical activity intervention that includes exercise instructions via
mailings and an interactive voice response system and followed for subsequent cardiovascular outcomes. We
propose an ancillary study (WHISH STAR) designed to take advantage of the infrastructure established by
WHISH and to add a cardiac monitoring component to detect silent AF in a subset of women at high risk for AF.
The primary purpose of WHISH STAR is to study the effects of PA on atrial fibrillation. Our central hypothesis
is that physical activity intervention reduces rates of clinical and silent AF. We will achieve our objective by
addressing the following aims: 1) To study the effect of physical activity intervention on standard clinical AF in
older women. Women without baseline AF will be followed for standard, clinical AF with adjudicated chart
reviews and Medicare linkage data. 2) To study the effect of physical activity intervention on silent AF in
women with high AF risk. Women at high risk of developing AF, defined as a 10-year Framingham risk of ≥
12% will undergo 14-day cardiac patch ECG monitoring at baseline, 6 months and 1 year. 3) To determine if
changing from a sedentary state to an active state results in a decrease in AF risk. This proposal is innovative
because a large prospective physical activity intervention trial to study the effects on atrial fibrillation has never
been done and this study leverages the infrastructure of the parent WHISH trial, which will minimize funds
needed for consent or outcome assessment, but adds significantly to the existing study by including validation
of outpatient episodes of AF. The team assembled has extensive experience in the ascertainment of AF in the
WHI, expertise in clinical trial design, insight into the epidemiology of cardiac screening, statistical expertise
and the organizational tools necessary to successfully complete the study. This study will be significant
because it will have an immediate impact on the advice regarding physical activity that is given to older
populations at risk for AF ...

## Key facts

- **NIH application ID:** 10146452
- **Project number:** 5R01HL136390-05
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** MARCO V PEREZ
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $597,195
- **Award type:** 5
- **Project period:** 2017-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10146452

## Citation

> US National Institutes of Health, RePORTER application 10146452, The WHI Strong and Healthy SilenT Atrial fibrillation Recording study (WHISH STAR) (5R01HL136390-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10146452. Licensed CC0.

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