Atrial fibrillation (AFib) carries a more somber prognosis for women than for men, prompting researchers to take a closer look at potentially predictive characteristics in women, according to research published by JAMA Network Open.

Lu Z, Aribas E, Geurts S, et al. Association between sex-specific risk factors and risk of new-onset atrial fibrillation among women. JAMA Network Open. 2022;5(9):e2229716.

To help mitigate the risk of AFib, physicians can urge patients at risk to stick to a heart-healthy diet, implement cardio in their exercise routines, and forgo alcohol and smoking.

Sex-specific risk factors for AFib

AFib is the most commonly occurring arrhythmia. Researchers at Johns Hopkins Medicine found that it was responsible for 15%–20% of all strokes, and most strokes resulting from AFib lead to permanent disability or death.

Blumenthal R, Calkins H. Atrial fibrillation: Prevention, treatment and research. Johns Hopkins Medicine. 2022.

There is no shortage of risk factors for AFib. Age (especially > 65 years), along with high blood pressure, are the main ones, but other potential contributors are obesity, diabetes, heart disease, heart failure, and lung disease, according to the Cleveland Clinic.

Atrial fibrillation (Afib). Cleveland Clinic. May 1, 2022.

In addition, sex-specific risk factors have been identified in women, who generally suffer worse health outcomes due to AFib than men.

The JAMA Network Open researchers reviewed data from the 2006–2010 UK Biobank study, which had a cohort of over 500,000 female participants between the ages of 40–69.

The analysis was based on data from 235,191 women participants, with an average age of 55.7 years. None of them had been diagnosed with AFib at the start of the study, but all had a history of hysterectomy and/or bilateral oophorectomy.

Upon follow-up with participants in October 2020, researchers found that 4,629 (2%) of the women exhibited new-onset AFib. The sex-specific risk factors associated with the development of AFib were early or delayed menarche, as well as early or delayed menopause.

Nulliparity and multiparity also both significantly heightened the risk of AFib in these women.

The results highlight the importance of taking into account the reproductive history of women in devising screening strategies for AF [AFib] prevention.

Future AFib screening may therefore pay more attention to reproductive characteristics, as the range of risk factors for women expands.

Tips to prevent AFib

Although further research is needed to better understand the connection between reproductive history and AFib in women, there are actions patients can take to lower their risk of developing this arrhythmia.

The Cleveland Clinic and Johns Hopkins researchers offered the following recommendations:

• Eat for a healthy heart. The Mediterranean diet is a great starting point. Patients can incorporate a generous amount of plant-based foods, including plenty of fruits and vegetables, into their diets. Steering clear of saturated fats may also boost heart health.

• Stay active. Encourage patients to try to complete at least 150 minutes of aerobic exercise per week. Once they know the target heart rate for their age, they can reach it with aerobic movement.

• Cut down on alcohol. Alcohol can elevate the risk of AFib, so the less of it in the body, the better.

• Ditch tobacco. This one may be a challenge for patients who use it regularly. Remind them that there are resources and support available to help them cut back.