Men Develop AF A Decade Earlier Than Women
Men develop atrial fibrillation (AF) about a decade earlier than women, on average, according to the findings of a recent study. Additionally, AF was associated with significantly increased mortality risk, regardless of sex.
In their study, the researchers examined the incidence of AF among a cohort of 79,793 individuals without AF at baseline who were involved in 4 community-based European studies that were a part of the BiomarCaRE consortium (median age 49.6 years, 51.7% were women). Participants were followed for a median 12.7 years. The researchers assessed the association between AF and mortality, common risk factors, biomarkers, the prevalence of cardiovascular disease, and the risk for AF by sex.
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Overall, more cases of AF were observed among men compared with women (2465 [6.4%] vs 1796 [4.4%]), and cardiovascular disease was more prevalent in men. For men, cardiovascular risk factor distribution and lipid profile at baseline were less beneficial than in women.
However, the lifetime risk was similar for both sexes, with the cumulative incidence of AF increasing significantly after 50 years of age in men and 60 years of age in women. Compared with those without AF, participants with AF had a 3.5-fold increased risk of death.
Multivariable-adjusted models revealed that the association between body mass index and AF was modified by sex. Total cholesterol was inversely associated with AF among women, with a lower risk for AF among those with lower total cholesterol levels. However, no sex differences were observed for C-reactive protein and N-terminal pro B-type natriuretic peptide.
The population-attributable risk for all risk factors combined was 46% among men and 41.9% among women, with about 20% of the risk associated with body mass index.
“Lifetime risk of AF was high, and AF was strongly associated with increased mortality both in women and men. Body mass index explained the largest proportion of AF risk,” the researchers concluded. “Observed sex differences in the association of body mass index and total cholesterol with AF need to be evaluated for underlying pathophysiology and relevance to sex-specific prevention strategies.”
—Melissa Weiss
Reference:
Magnussen C, Niiranen TJ, Ojeda F, et al. Sex differences and similarities in atrial fibrillation epidemiology, risk factors, and mortality in community cohorts: results from the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe) [published online October 16, 2017]. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.117.028981.