Older Women At Risk Due to Disparities in Cardiovascular Care

A recent study suggests that sex-based discrepancies in cardiovascular care may contribute to the higher stroke risk among females with atrial fibrillation.

The findings, conducted by Women's College Hospital, the Peter Munk Cardiac Centre (PMCC) at University Health Network (UHN), and ICES, say one in four strokes after age 40 is brought on by atrial fibrillation (AF), a typical irregular heartbeat. AF raises the risk of stroke.

According to earlier research, having a female sex identity increases the risk of an AF-related stroke.


Now, a recent study found that women with AF only have a greater risk than men if they also have another risk factor for stroke.

The causes of this increased stroke risk in women have not been thoroughly investigated. Instead of the female sex being inherently predisposed to this increased risk, the authors reasoned that these risk factors were less effectively managed in older females.

The population-based cohort research, written in the European Heart Journal, examined medical records of seniors 65 and older who had just been diagnosed with AF in Ontario, Canada. The cohort included 354,254 members, with 49% women and an average age of 78.

After accounting for differences in cardiovascular care and age of the individual, lead author Hifza Buhari of the University of Toronto and a former Temerty medical student at Women's College Hospital says the data show that stroke risk was comparable for men and women under the age of eighty, but that female sex was an independent risk factor over the age of eighty.

In addition, Buhari notes that women are more likely to be identified with atrial fibrillation later in life and may not be getting the proper care to lower their risk of stroke.

The results also indicate that females received more emergency room diagnoses than males. In the years before and after the AF diagnosis, women also had fewer visits with cardiologists.

What kind of cardiovascular care do women need?

Equalizing cardiovascular treatment for men and women is a crucial step toward everyone having better hearts and lives, according to senior author Husam Abdel-Qadir. We can improve the possibility that every person has the best chance for a heart-healthy future by eliminating sex disparities.


The fact that the researchers were unable to control for characteristics like race, the kind or severity of AF, and other clinical parameters is one of the data's limitations. As a result, it's possible that the disparities in cardiovascular care that disproportionately impact older women were underreported.

Per Abdel-Qadir, the findings serve as another reminder that heart disease and stroke are not just a problem for men. Even though it is widely acknowledged that women with AF have a greater risk of stroke than men, they receive less treatment, which has actual repercussions.

The NHS says eating a low-fat, high-fiber diet rich in whole grains and fresh fruit and vegetables daily is recommended for a healthy heart. The maximum amount of salt one should consume daily is six grams, as eating more than that can raise blood pressure.


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