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Sex differences and AFib: New study flips conventional wisdom

Science has long shown that men are at greater risk for developing atrial fibrillation (AFib) than women; but it has never been fully understood why women would be protected from developing the condition. New research from the Smidt Heart Institute at Cedars-Sinai challenges this conventional wisdom by demonstrating that women — when height is accounted for — have a 50% higher risk of developing the abnormal heart rhythm disturbance when compared to men.

The novel findings, published today in the peer-reviewed journal JAMA Cardiology, suggest medical practitioners must remain vigilant in promoting AFib prevention — and early interventions — among both female and male patients.

“This is the first study to show an actual flip in the risk of atrial fibrillation,” said Christine Albert, MD, MPH, chair of the Department of Cardiology in the Smidt Heart Institute and senior author of the JAMA Cardiology study. Albert also led the national VITAL Rhythm Trial upon which these findings are based. “In this population of 25,000 individuals without prior heart disease, after adjusting for differences in height, women were at higher risk for developing AF than their male counterparts — upward of 50%.”

As Albert explains, the taller an individual is, the more at risk they are for AFib. This is why women have been shown to have a lower risk of the disease, since they tend to be shorter than men.

“Our study, however, surprisingly suggests that if a man and a woman have the same height, the woman would be more likely to develop AFib,” said Albert. “Now the question has changed: Instead of why are women protected, now we must seek to understand why women are at a higher risk.”

Atrial fibrillation is the most common type of abnormal heart rhythm and, without treatment, can lead to stroke or heart failure. Once a woman is diagnosed with AFib, she is more likely to experience one of these adverse consequences than a man, making AFib prevention exceedingly important in women.

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