title: Risk factors for atrial fibrillation and their population burden in postmenopausal women: the Women's Health Initiative Observational Study.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is the most common arrhythmia in women. Large studies evaluating key AF risk factors in older women are lacking. We aimed to identify risk factors for AF in postmenopausal women and measure population burden of modifiable risk factors.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  The Women's Health Initiative (WHI) Observational Study.
  
  
  METHODS
  93 676 postmenopausal women were followed for an average of 9.8 years for cardiovascular outcomes. After exclusion of women with prevalent AF or incomplete data, 8252 of the remaining 81 892 women developed incident AF.
  
  
  METHODS
  Incident AF was identified by WHI-ascertained hospitalisation records and diagnosis codes from Medicare claims. Multivariate Cox hazard regression analysis identified independent risk factors for incident AF.
  
  
  RESULTS
  Age, hypertension, obesity, diabetes, myocardial infarction and heart failure were independently associated with incident AF. Hypertension and overweight status accounted for 28.3% and 12.1%, respectively, of the population attributable risk. Hispanic and African-American participants had lower rates of incident AF (HR 0.58, 95% CI 0.47 to 0.70 and HR 0.59, 95% CI 0.53 to 0.65, respectively) than Caucasians.
  
  
  CONCLUSIONS
  Caucasian ethnicity, traditional cardiovascular risk factors and peripheral arterial disease were independently associated with higher rates of incident AF in postmenopausal women. Hypertension and overweight status accounted for a large proportion of population attributable risk. Measuring burden of modifiable AF risk factors in older women may help target interventions.
authors.affiliation: 1Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California, USA. mvperez@stanford.edu
authors.forename: Marco V
authors.initials: MV
authors.lastname: Perez
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Wang
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Larson
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
authors.forename: Marian
authors.initials: M
authors.lastname: Limacher
authors.forename: Beatriz
authors.initials: B
authors.lastname: Rodriguez
authors.forename: Liviu
authors.initials: L
authors.lastname: Klein
authors.forename: Joann E
authors.initials: JE
authors.lastname: Manson
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Martin
authors.forename: Ronald
authors.initials: R
authors.lastname: Prineas
authors.forename: Stephanie
authors.initials: S
authors.lastname: Connelly
authors.forename: Mark
authors.initials: M
authors.lastname: Hlatky
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D017698:Postmenopause / Q000208:ethnology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health / Q000208:ethnology