Studies revive calls for women’s heart health to be better explored

Atrial fibrillation is a type of irregular heart rhythm, or arrhythmia, that reduces the heart’s ability to pump blood properly. It may lead to blood clots, stroke, heart failure, or other cardiovascular complications and is the most common cardiac arrythmia in many developed countries including the US and Australia.

This week 2 new scientific studies investigating atrial fibrillation (AF) in women have been published, highlighting the importance of studying cardiovascular health in women.

The first, published in the Journal of the American Heart Association, has found that about 1 in 4 women may develop AF after menopause, and that stressful life events and poor sleep are leading factors.

According to the researchers, emerging studies have shown that psychosocial factors can potentially impact AF, but information in older women remains limited.

They analysed more than 83,000 questionnaires by women aged 50-79, from the Women’s Health Initiative, which covered key categories such as: stressful life events, sense of optimism, social support, and insomnia.

During approximately a decade of follow up, the study found that about 1 in 4 women developed atrial fibrillation. But for each additional point on the stressful life event scale, there was a 2% higher likelihood of having atrial fibrillation. For each additional point on the insomnia scale that number rose to 4%.

“The heart and brain connection has been long established in many conditions,” says lead author Dr Susan X. Zhao, a cardiologist at Santa Clara Valley Medical Center in the US.

“Atrial fibrillation is a disease of the electrical conduction system and is prone to hormonal changes stemming from stress and poor sleep. These common pathways likely underpin the association between stress and insomnia with atrial fibrillation.”

The second paper in the European Heart Journal explored the higher risk of stroke seen among women with AF, and found that it is potentially related to sex-based disparities in cardiovascular care.

The study analysed health records for people aged 65 and older, recently diagnosed with AF in Ontario, Canada. This included 354,254 people, 49% of which were female.

It found that, compared to males, females were diagnosed with AF at an older age and more often in emergency departments. They also received fewer cardiologist appointments in the year before and after AF diagnosis.

“After taking into account the age of the individual and differences in cardiovascular care, the data show that stroke risk was similar between males and females under the age of eighty, but that female sex was an independent risk factor over the age of eighty,” says lead author Hifza Buhari, family medicine resident at the University of Toronto.

“Females tend to be diagnosed with atrial fibrillation at older ages, and they may not be receiving adequate monitoring or treatment to reduce their stroke risk.”