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Sex Differences in Risk Factors for Incident Atrial Fibrillation: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study
Abstract

Sex Differences in Risk Factors for Incident Atrial Fibrillation: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Abhishek Bose, Wesley O’Neal, Chengyi Wu, Leslie McClure, Suzanne Judd, Virginia Howard, George Howard and Elsayed Soliman
Circulation (New York, N.Y.), v 138(Suppl 1), 12700
06 Nov 2018

Abstract

Background Women are less likely to develop atrial fibrillation (AF) compared with men. It is unclear if this is related to difference in risk factors leading to AF or due to a differential impact of the same risk factors between sexes. Methods This analysis included 11,806 participants (55.2 % women) free of AF at baseline from the REGARDS study. Incident AF was ascertained by study-scheduled electrocardiograms and self-reported history at a follow-up examination. Logistic regression was used to examine baseline associations with incident AF. Backwards elimination logistic regression was used to identify AF risk factors in men and women, separately. Results Over a median follow-up of 9.0 years, 588 (11.1%) men and 428 (6.6%) women (p-value <0.001) developed AF. Men had a higher risk of AF than women in a logistic regression model adjusted for age and race [OR (95%CI)1.61(1.26, 1.75)]. Age, white race, height, weight, use of blood pressure lowering medications and history of cardiovascular disease were identified by backward elimination as AF risk factors shared by both sexes. On the other hand, diabetes was an AF risk factor in women but not in men (Table). Among the shared risk factors between men and women, only age showed a stronger association in women than in men [Interaction p-value=0.003]. Adjustment for the shared risk factors eliminated the sex difference in AF risk [OR (95%CI)0.90 (0.74, 1.09)], which was more noticeable in those younger than the median age (62 years) compared to those who were older [interaction p-value 0.003]. Conclusions Women and men share several AF risk factors, and these shared risk factors explain the sex differences. However, age association with AF differs by sex, and age modifies the associations between sex and other AF risk factors.

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