These traits may heighten risk of AFib in women: What you need to know

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published January 16, 2023

Key Takeaways

  • Women are at higher risk than men for developing new-onset atrial fibrillation (AFib).

  • Certain aspects of reproductive history—such as irregular menstrual cycles, multiparity, and nulliparity—place some women at increased risk for AFib.

  • While some risk factors are out of patients’ control, physicians can remind them to eat heart-healthy meals, stay active, and avoid smoking and alcohol in an effort to prevent the development of AFib.

Atrial fibrillation (AFib) carries a more somber prognosis for women than for men, prompting researchers to take a closer look at potentially predictive characteristics in women, according to research published by JAMA Network Open.[]

To help mitigate the risk of AFib, physicians can urge patients at risk to stick to a heart-healthy diet, implement cardio in their exercise routines, and forgo alcohol and smoking.

Sex-specific risk factors for AFib

AFib is the most commonly occurring arrhythmia. Researchers at Johns Hopkins Medicine found that it was responsible for 15%–20% of all strokes, and most strokes resulting from AFib lead to permanent disability or death.[]

CDC researchers publishing in The American Journal of Cardiology predict that AFib will affect 12.1 million people across the US by 2030.[]

There is no shortage of risk factors for AFib. Age (especially > 65 years), along with high blood pressure, are the main ones, but other potential contributors are obesity, diabetes, heart disease, heart failure, and lung disease, according to the Cleveland Clinic.[]

In addition, sex-specific risk factors have been identified in women, who generally suffer worse health outcomes due to AFib than men.

The JAMA Network Open researchers reviewed data from the 2006–2010 UK Biobank study, which had a cohort of over 500,000 female participants between the ages of 40–69.

The analysis was based on data from 235,191 women participants, with an average age of 55.7 years. None of them had been diagnosed with AFib at the start of the study, but all had a history of hysterectomy and/or bilateral oophorectomy.

Upon follow-up with participants in October 2020, researchers found that 4,629 (2%) of the women exhibited new-onset AFib. The sex-specific risk factors associated with the development of AFib were early or delayed menarche, as well as early or delayed menopause.

Nulliparity and multiparity also both significantly heightened the risk of AFib in these women.

"The results highlight the importance of taking into account the reproductive history of women in devising screening strategies for AF [AFib] prevention."

Lu, et al., JAMA Network Open

Future AFib screening may therefore pay more attention to reproductive characteristics, as the range of risk factors for women expands.

Tips to prevent AFib

Although further research is needed to better understand the connection between reproductive history and AFib in women, there are actions patients can take to lower their risk of developing this arrhythmia.

The Cleveland Clinic and Johns Hopkins researchers offered the following recommendations:

  • Eat for a healthy heart. The Mediterranean diet is a great starting point. Patients can incorporate a generous amount of plant-based foods, including plenty of fruits and vegetables, into their diets. Steering clear of saturated fats may also boost heart health.

  • Stay active. Encourage patients to try to complete at least 150 minutes of aerobic exercise per week. Once they know the target heart rate for their age, they can reach it with aerobic movement.

  • Cut down on alcohol. Alcohol can elevate the risk of AFib, so the less of it in the body, the better.

  • Ditch tobacco. This one may be a challenge for patients who use it regularly. Remind them that there are resources and support available to help them cut back.

Not every AFib risk factor can be modified by patient behavior. But physicians can help guide patients in mitigating the contributing factors that they can address—and in doing so, help them maintain a healthy heart.

What this means for you

AFib is the most common type of abnormal heartbeat and has a poorer prognosis in women than in men. Reproductive factors such as nulliparity, multiparity, early and late menopause, and a history of irregular periods appear to raise the risk of developing AFib. You may want to screen patients accordingly. Help them lower their risk for AFib by encouraging them to exercise, eat heart-healthy meals, and quit tobacco and alcohol.

Read Next: Challenging conventional wisdom: AFib and the sexes
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