Epidemiology, diagnosis, and management of atrial fibrillation in women

Abstract

Atrial fibrillation (AF) is the most common arrhythmia and has become a serious public health problem. Moreover, epidemiological data demonstrate that incidence and prevalence of AF are increasing. Several differences in epidemiological patterns, clinical manifestations, and incidence of stroke have been reported between AF in women and in men, particularly in elderly women. Elderly women have higher blood pressure than men and a higher prevalence of heart failure with preserved ejection fraction, both independent risk factors for stroke. On the basis of the evidence on the higher stroke risk among AF in women, recently, female sex has been accepted as a risk factor for stroke and adopted to stratify patients, especially if they are not at high risk for stroke. This review focuses on available evidence on sex differences in AF patients, and examines factors contributing to different stroke risk, diagnosis, and prognosis of arrhythmia in women, with the aim to provide an analysis of the available evidence.

Cardiovascular Disease in Women

“…Women also have an increased lifetime prevalence of stroke risk factors, including hypertension, as well as abdominal obesity and metabolic syndrome, especially in middle-aged women. Incidence of AF is lower in women compared to men 196 ; however, women suffering from AF show a higher incidence of stroke and a higher mortality rate with respect to men. A recently published meta-analysis evaluated 30 studies with 4,371,714 participants addressed whether AF is a stronger risk factor for stroke, CVD death, all-cause mortality, and other outcomes in women compared with men.…”

Focused Cardiovascular Care for Women

“…The incidence of AF is lower in women than in men 100 ; however, women who have AF show a different prognosis, with a higher incidence of stroke and a higher mortality rate than those observed in men. 100 Risk assessment of women for stroke should take into account age-and sex-specific differences. The CHADS 2 -Vasc score is an extension of the CHADS 2 score that adds an extra point for female sex.…”

Perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation—An interview study

“…Moreover, women over 65 years with AF have also an increased risk of developing stroke (40). In addition, men seem to have a higher cardiovascular risk factor profile (41), such as hypertension, obesity and metabolic syndrome, which increases the risk of stroke (42). Regarding to treatment, women receive less cardioversion as well as more rate control medications than men (38).…”