NEW YORK (Reuters Health) - Women with atrial fibrillation (AF) are at somewhat higher risk of death and cardiovascular disease (CVD) than men with the condition, a new systematic review and meta-analysis confirms.
"Physicians should be aware of this and they should also make sure they treat women as aggressively as men," Connor Emdin, a doctoral student at The George Institute for Global Health at the University of Oxford, U.K., told Reuters Health. "On average, women should probably be treated moreaggressively."
Smoking and diabetes are known to increase coronary heart disease risk more sharply for women than for men, Emdin and his team write in their report, online January 19 in The BMJ. Some studies have found that AF is more strongly associated with stroke and death in women than in men, but other studies have not, they add.
To better understand the relationship, the researchers looked at 30 studies including more than 4.3 million individuals. The ratio of relative risk for women compared to men with AF for all-cause mortality was 1.12. For stroke, the ratio was 1.99, while it was 1.93 for cardiovascular mortality, 1.55 for cardiac events, and 1.16 for heart failure. All increases were statistically significant.
While the CHADS2 score for estimating stroke risk in AF does not include female sex as a risk factor for stroke, Emdin noted, a more recent version, the CHA2DS2-VASc score, does. "Our results would support using risk scores which include female sex," he said.
AF is less prevalent among women than men, but thefindings confirm that it is more severe for them as well, Dr. Elsayed Soliman, director of the Epidemiological Cardiology Research Center at Wake Forest Baptist Medical Center in Wake Forest, North Carolina, told Reuters Health. Dr. Soliman was not involved in the new study.
"The article adds to this evidence that really women are different from men when it comes to cardiovascular disease and they need to be managed differently," Dr. Soliman said. He added that "we need to do more work to see what could bridge the gap in outcomes associated with atrial fibrillation."