Sex-based disparities in cardiovascular care could also be linked to higher stroke risk amongst females

Higher stroke risk amongst females with atrial fibrillation could also be related to sex-based disparities in cardiovascular care, based on a brand new study from Women’s College Hospital, the Peter Munk Cardiac Centre (PMCC) at University Health Network (UHN) and ICES.

Atrial fibrillation (AF) is a typical style of irregular heart rhythm that’s related to a better risk of stroke-;after the age of 40, one in 4 strokes are brought on by AF. Previous studies have found that female sex (assigned at birth) is a risk factor for AF-associated stroke. Recent research suggested that females are only at higher risk than males with AF in the event that they have one other factor predisposing them to stroke (reminiscent of older age, hypertension, or diabetes).

The explanations for this higher stroke risk in females has not been well-examined. The authors hypothesized this was because these risk aspects were less well-treated in older females, slightly than female sex intrinsically predisposing to this higher risk.

The population-based cohort study, published within the European Heart Journal, analyzed health records for people aged 65 and older recently diagnosed with AF in Ontario, Canada. The cohort included 354,254 people (49% female), with a median age of 78 years. The study was made possible through the Early Profession Women’s Heart and Brain Health Chair and a National Recent Investigator Award from the Heart and Stroke Foundation of Canada.

After making an allowance for the age of the person and differences in cardiovascular care, the info show that stroke risk was similar between women and men under the age of eighty, but that female sex was an independent risk factor over the age of eighty. Females are inclined to be diagnosed with atrial fibrillation at older ages, they usually might not be receiving adequate monitoring or treatment to scale back their stroke risk.”

Hifza Buhari, lead writer, family medicine resident on the University of Toronto and former Temerty medical student at Women’s College Hospital

The info also show that, in comparison with males:

• Females were diagnosed more often in emergency departments (30% versus 25% for males)
• Females received fewer cardiologist appointments, each within the 12 months before (12% versus 17%) and after (31% versus 37%) AF diagnosis.
• Females were also less prone to get LDL-C testing and be treated with statins, despite having higher LDL-C levels and better BP than their male counterparts.

“Equalizing cardiovascular look after women and men is a crucial step towards healthier hearts and lives for everybody,” says senior writer Husam Abdel-Qadir, cardiologist at Women’s College Hospital and Peter Munk Cardiac Centre, University Health Network, and scientist with Women’s College Research Institute, Ted Rogers Centre for Heart Research, and ICES. “By addressing sex inequities, we are able to increase the likelihood that each individual receives the very best likelihood at a heart-healthy future.”

One limitation of the info is that the researchers couldn’t account for variables reminiscent of race, AF type or severity, and other clinical aspects, which can had led to an underestimation of inequities in cardiovascular care that disproportionately affect older females.

“This study is one other reminder that heart disease and stroke usually are not male diseases. Despite there being widespread appreciation that females with AF are at higher stroke risk than males, they’re getting less cardiovascular care with real consequences. These data emphasize that females, particularly those at older ages, require appropriate care to scale back their risk of those serious diseases,” says Dr. Abdel-Qadir.