What Women Need to Know About AFib 

It’s common practice in modern medicine to treat the disease instead of the individual. Atrial fibrillation is atrial fibrillation, right? Wrong. While it may be the most common heart arrhythmia, affecting over 43 million people worldwide, the condition impacts men and women very differently. Today, we give much-needed attention to women suffering from AFib.

How common is atrial fibrillation in women?

Let’s start with some good news, ladies! Atrial fibrillation is less common in women than in men. The most recent data indicates that 373 per 100,000 women get AFib, while men have substantially higher rates at 596 per 100,000. However, it’s important to remember that women often suffer from symptoms in silence, so actual rates could be higher.  

And yet, even though women are diagnosed with AFib at lower rates, more women live with AFib. How can this be? Simple: women tend to live longer than men. 

How does AFib look different in women?

It’s difficult to generalize any illness, as symptoms vary from person to person. However, there are ways that AFib may look different in women.

Age

On average, men are diagnosed with AFib an entire decade earlier than women. While the reasons are unclear, AFib rates rise sharply in men when they hit 50 years of age, while women’s risk does not substantially increase until they are 60. These numbers align with the CDC data, which reports that the average age for men with AFib is 67, and for women, it’s 75. As with most health matters, advancing age is a risk factor for AFib. Presentation

The symptoms that women experience with AFib are often different from those that men experience. Because women generally have smaller hearts (physiologically, that is), they tend to have slightly higher resting heart rates than men. 

Since AFib makes the heart beat faster, women may feel those differences more quickly. AFib also causes heart palpitations, which may be more frequent and easily felt in a woman’s more petite frame. In addition to a faster heart rate and more palpitations, women may experience:

  • Longer AFib episodes
  • More frequent attacks of AFib
  • Fatigue and weakness
  • Difficulty sleeping

Risk Factors

The factors contributing to AFib differ based on sex. Women with AFib are more likely to have high blood pressure and damaged heart valves. In contrast, men typically have higher rates of coronary artery disease. In addition, structural differences in females, such as smaller heart size and a higher likelihood of thickening and scarring of the atria, may also contribute.

Complications

Unfortunately, and for reasons not well understood, women with AFib tend to have poorer outcomes than men. Not only are they at higher risk of stroke, but if they do have a stroke, the symptoms tend to be more severe. Women also face more significant challenges when it comes to getting their AFib under control.

Treatment

There are typically two conventional treatments for AFib: rate control and rhythm control. Rhythm control treatments attempt to bring the heart back to normal sinus rhythm and include procedures such as cardioversion or ablation. 

On the other hand, rate control treatments typically involve administering medications to lower the heart rate. Women are much more likely to be treated with rate control strategies instead of rhythm control. According to a recent study, women are also less likely to be prescribed medication to thin the blood; a standard clinical practice used to prevent blood clots.  

Mortality

While women are less likely to be diagnosed with AFib, scientists have determined that they are more likely than their male counterparts to have adverse outcomes. Compared to men, women with atrial fibrillation had higher rates of cardiac events, heart failure, stroke, and eventually, death. 

Can menopause cause arrhythmia?

Up to 25 percent of women experience heart palpitations during menopause, and the exact cause is unclear. However, it is suspected that fluctuations in hormones such as estrogen and progesterone may contribute to irregularities in heart rhythms. 

Very few studies have examined the relationship between menopause and atrial fibrillation. One recent study concluded that AFib is not linked to menopausal age. However, the estrogen replacement therapy sometimes prescribed to minimize menopausal symptoms does increase atrial fibrillation risk. 

While menopause might not cause AFib directly, the hormonal changes associated with menopause contribute to other predisposing factors for AFib, such as high blood pressure, diabetes, high cholesterol, and weight gain.

AFib symptoms in elderly women

The likelihood of developing atrial fibrillation rises with age. Symptoms to look for include: 

  • Heart palpitations, skipped beats, thumping, a feeling that the heart is out of sync
  • Feeling that the heart is racing, pounding, or going very fast
  • Feeling more tired than usual, often described as exhausted
  • Shortness of breath
  • Dizziness or feeling light-headed
  • Pain or discomfort in the chest
  • Feeling disoriented or confused
  • Sweating 
  • Feeling anxious, panicked, or experiencing a general sense that something is wrong

Unfortunately, some of the symptoms of AFib in older patients may mimic typical signs of aging, making AFib easy to overlook. For example, it’s not incredibly uncommon for an older adult to experience fatigue, dizziness, or confusion. 

In addition, a recent study found that seniors diagnosed with AFib are more likely to develop walking problems, including reduced strength and balance. Therefore, physicians must consider a careful cardiac assessment for older women experiencing any of the above symptoms. 

Are women’s health complaints taken less seriously? 

A sad reality in today’s world is that women’s health complaints are often minimized or dismissed altogether. Heart palpitations are sometimes brushed off as hormonal changes. A feeling of a racing heart is diagnosed as anxiety. Unfortunately, studies have found that women are much more likely to be misdiagnosed regarding cardiac issues than their male counterparts. 

Women who are experiencing cardiac symptoms, especially if they are new, should seek immediate medical care. If you suspect that you are in AFib, log your symptoms, request an EKG and cardiac consult, and bring a patient advocate with you who can help speak to your concerns. 

Next steps

AFib looks different in women than it does in men. While fewer women are diagnosed with arrhythmia, they typically face poorer outcomes. However, knowledge is power.

There are many things that you can do today to reduce your risk of AFib. Start by eating a whole-food, nutrient-dense diet. Next, reduce sugar, stress, and toxins. Get plenty of rest. Make an appointment with a practitioner at Natural Heart Doctor and get a holistic healthcare professional on your team. Finally, spend time with those you love. A full heart is a healthy heart.

Eat Well · Live Well · Think Well 


Medical Review 2022: Dr. Lauren Lattanza NMD

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