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Atrial Fibrillation Manifestations Risk Factors and Sex Differences in a Population-Based Cohort (From the Gutenberg
Christina Magnussen1, Francisco M Ojeda1, Philipp S Wild2
1Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Men have a higher prevalence of atrial fibrillation (AF) and worse cardiovascular risk factors than women. However, women experience more symptoms, highlighting significant sex differences in AF presentation and predictors.
Area of Science:
- Cardiology and Cardiovascular Diseases
- Epidemiology and Population Health
- Sex Differences in Health
Background:
- Systematic investigation of sex differences in atrial fibrillation (AF) risk factors, cardiac characteristics, and disease burden at the population level is lacking.
- Previous studies have not fully elucidated how cardiovascular risk factors, cardiac structure, and symptom burden differ between men and women with AF.
Purpose of the Study:
- To investigate sex differences in cardiovascular risk factors, cardiac structure and function, and disease and symptom burden in atrial fibrillation (AF).
- To determine sex-specific predictors for AF within a large, population-based cohort.
Main Methods:
- Utilized cross-sectional data from 14,796 participants (aged 35-74 years) of the population-based Gutenberg Health Study.
- Analyzed the distribution of cardiovascular risk factors by AF status and sex.
- Employed age-adjusted and multivariable-adjusted Cox regression models to identify sex-specific predictors for AF, examining interactions.
Main Results:
- AF prevalence was higher in men (4.3%) than in women (1.9%).
- Men exhibited a poorer cardiovascular risk factor profile and higher cardiovascular disease prevalence but reported fewer symptoms than women.
- Significant sex interactions were observed for predictors including high-density lipoprotein-cholesterol, triglycerides, diabetes mellitus, coronary artery disease, myocardial infarction, generalized anxiety disorder, heart rate, interventricular septum thickness, and left atrial diameter index.
Conclusions:
- Substantial sex differences exist in the distribution, clinical characteristics, comorbidities, symptom burden, and structural cardiac changes associated with atrial fibrillation (AF).
- These findings underscore the importance of considering sex as a biological variable in AF research and clinical practice.
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