Atrial fibrillation is a stronger risk factor for cardiovascular disease, stroke, and death in women compared with in men, according to research published in BMJ.

“A growing body of literature suggests that women and men experience risk factors for cardiovascular disease differently,” reported study author Connor A. Emdin, PhD student at George Institute for Global Health at the University of Oxford in the United Kingdom, and colleagues.

In a meta-analysis of 30 cohort studies published between January 1966 and March 2015, the researchers identified an association between atrial fibrillation in women and an elevated risk of all-cause mortality, stroke, cardiovascular mortality, cardiac events, and heart failure (ratio of relative risks compared with men, 1.12), as well as a significantly higher risk of stroke (1.99), cardiovascular mortality (1.93), cardiac events (1.55) and heart failure (1.16).

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Selected studies had a minimum of 50 participants with atrial fibrillation and a minimum of 50 participants without atrial fibrillation, and reported on sex-specific associations between atrial fibrillation and all-cause and cardiovascular mortality, stroke, cardiac events including cardiac death and nonfatal myocardial infarction, and heart failure. In total, data for 4,371,714 participants were analyzed.

“Our results indicate that atrial fibrillation is associated with worse outcomes in women than in men,” the researchers concluded. “It may be appropriate for clinicians to consider more aggressive treatment of risk factors in women with atrial fibrillation as they seem to be at higher proportional risk of death and cardiovascular disease”


  1. Emdin CA, Wong CX, Hsiao AJ, et al. Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies. BMJ. 2016; doi: 10.1136/bmj.h7013