Women with atrial fibrillation are at significantly higher risk of stroke and death compared to men
The results of the review of previous studies published in the September issue of Gender Medicine.
Atrial fibrillation is a cardiovascular disorder affecting 2.2 million people in the United States. During atrial fibrillation, the atria of the heart, which are two small upper chambers, quiver instead of beating effectively.
The blood is not pumped completely out of the atria, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and lodges in an artery in the brain, a stroke occurs.
In recent years, women have overtaken men in the prevalence and mortality due to cardiovascular disease.
“Stroke is one of the most devastating consequences of cardiovascular disease and atrial fibrillation increases the risk of stroke,” said the cardiologist Annabelle Volgman, medical director of Heart Center for Women at Rush University Medical Center and principal investigator the study. “Women are at greater risk of atrial fibrillation-related stroke than men and are more likely to live with disabilities associated with stroke that can significantly lower quality of life.”
“We reviewed previous studies address gender differences in atrial fibrillation in a 20-year period in order to identify gender differences for women and men with atrial fibrillation. As a result, we were able to determine how more rational, safe and effective gender-specific approach to therapy for women, “said Volgman.
The researchers identified the following gender differences for women and men with atrial fibrillation and develop management recommendations follows:
Women have a higher incidence of stroke and mortality than men.
Focusing on therapies to prevent atrial fibrillation and ensure the safe management once diagnosed.
Women are not prescribed blood thinners (anticoagulation) as often as are men, resulting in an increased incidence of blood clots that break loose and block other vessels.
Assess the risk / benefit for each individual woman with atrial fibrillation.
Women have an increased risk of bleeding from anticoagulation therapy than men.
Monitor carefully anticoagulant therapy to prevent bleeding.
Women have a higher risk of life-threatening arrhythmias and heart rate slow requiring a permanent pacemaker when treated with antiarrhythmic drugs.
Monitor female patients taking antiarrhythmic drugs carefully.
Women have hormonal fluctuations.
Please note that hormonal fluctuations during the normal menstrual cycle can cause more life-threatening arrhythmias.
Women have a higher risk of low potassium levels in the blood, increasing the risk of drug-related arrhythmias.
Monitor serum potassium levels carefully.
Women have an increased sensitivity to support therapies such as statins and vasodilators.
Pay close attention to the liver and kidney function.
Women are referred less often or later from lack of medicines management as the implantation of a pacemaker or ablation.
Remember that ablative therapy is an option for symptomatic women, because of the success rates similar in men.
Women with atrial fibrillation have a lower quality of life.
Careful assessment of symptoms, relief of symptoms and adequate rate control or rhythm control can improve quality of life.
“For women with atrial fibrillation, these gender differences should always be taken into account to help prevent strokes and heart failure and improve their quality of life,” said Volgman.
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