Abstract 1572: Independent Clinical Correlates of Atrial Fibrillation in Postmenopausal Women: The Women’s Health Initiative Observational Study
Background: Atrial fibrillation (AF) is the most common arrhythmia in women and is associated with increased risk of stroke and death. Although women are at lower risk of developing AF than men, the reasons for these differences are not well understood and large studies of risk factors for developing AF are lacking.
Methods: The Women’s Health Initiative Observational Study characterized 93,591 women who reported their demographic information, environmental exposures and medical history. Atrial fibrillation at baseline was identified by self report. Multiple logistic regression was used to identify independent risk factors for atrial fibrillation, including age, race, hypertension, diabetes, heart failure, coronary and peripheral vascular disease, hormone therapy use, hysterectomy and age at menarche.
Results: A total of 4,393 women (4.7%) were identified with atrial fibrillation. The participants were on average 63 years of age, 83% white and 41% had never taken hormone therapy. On multivariate logistic regression, we confirmed prior observations that age, heart failure, hypertension, diabetes and myocardial infarction were strongly and independently associated with prevalent atrial fibrillation. In addition, prior or current hormone therapy use (OR 1.11, p=0.003), early menarche (OR 1.21, p=0.007) and hysterectomy with or without bilateral oophorectomy (OR 1.25, p<0.001) were independently and significantly associated with AF. Peripheral vascular disease was strongly associated with AF (OR 1.81, p<0.001) independently of other cardiovascular diseases and risk factors. Hispanic ethnicity and Asian race were independently protective against AF (OR 0.82, 95%CI 0.67 0 1.0 and OR 0.81, 95% CI 0.66 –1.0 respectively).
Conclusions: Differential exposures to endogenous and therapeutic hormones may be modestly associated with atrial fibrillation independent of other cardiovascular risk factors. Coronary and peripheral vascular diseases are associated with an increased prevalence of AF in women.