January 15, 2024

1 in 4 Women Get Atrial Fibrillation After Menopause

Cardiovascular disease remains the primary cause of women’s mortality in the U.S., with studies indicating an escalated risk post-menopause. The standard resting heart rate hovers between 60 to 100 beats per minute (bpm). Yet, the disruptive atrial fibrillation (Afib) can propel your atria into a whirlwind, causing them to pound at an astonishing 300 to 600 beats per minute. 

Consequently, Afib presents the menacing potential for blood clot formation, strokes, heart failure, and a myriad of other cardiovascular complications. Primarily targeting the elderly populace, this condition forebodes a worrisome projection: over 12 million individuals in the U.S. are anticipated to grapple with atrial fibrillation by the year 2030, as per the American Heart Association’s forecasts.

Research update

A new study recently found that post-menopause, as many as one in four women experience an irregular heartbeat—a hefty 25% surge—often linked to sleep troubles and major life upheavals like divorces. This revelation stems from new research presented in the Journal of the American Heart Association, a journal widely accessible to all, and reviewed by peers associated with the American Heart Association.

The study, drawing from over 83,000 surveys conducted among women aged 50-79 involved in the Women’s Health Initiative, a substantial study in the U.S., delved into several pivotal areas. The participants were probed on various fronts: stressful life incidents, their optimism levels, the support they received from their social circles, and their sleep patterns. The queries about stressful incidents encompassed loss, illness, divorces, financial strains, and experiences of abuse—be it verbal, physical, or sexual. On the sleep front, the questions revolved around difficulties falling asleep, frequent awakenings during the night, and the overall quality of sleep. Additionally, the survey inquired about the participants’ general outlook on life and the assistance they received in daily chores and stressful situations from friends or family.

Over roughly ten years, the study unveiled several key findings:

  • Around 25%, approximately 23,954 women, encountered atrial fibrillation.
  • The study identified a two-pronged system: the stress cluster and the strain cluster.
  • For each incremental point on the insomnia scale, there was a 4% upsurge in the likelihood of developing atrial fibrillation. Similarly, for each additional point on the scale measuring stressful life incidents, the chances of developing atrial fibrillation increased by 2%.

The researchers highlighted the intricate links between stressful life episodes, poor sleep, and emotional states like depression, anxiety, or feeling overwhelmed by one’s circumstances. They expressed difficulty in determining whether these factors gradually accumulate over the years, increasing the risk of atrial fibrillation with age among women.

While chronic stress hasn’t consistently shown a direct link with atrial fibrillation, the researchers did acknowledge a limitation in their study—reliance on initial patient questionnaires. Stressful incidents, albeit significant and distressing, might not have a prolonged impact. They emphasize the need for further research to affirm these connections and explore whether personalized stress-alleviating interventions could potentially mitigate the risk of atrial fibrillation.

Study details and background

Between 1994 and 1998, a cohort of 83,736 women was assembled for this study. These women, averaging around 64 years old, composed a diverse group: approximately 88% identified themselves as white, 7.2% as Black, and 2.9% as Hispanic. 

Exploring the realms of longevity, it’s evident that women, living longer lives, confront escalated risks and diminished outcomes linked with atrial fibrillation. 

Established risk factors like high blood pressure, obesity, Type 2 diabetes, and heart failure are acknowledged, yet delving into uncharted territories, such as the impact of psychosocial stress and emotional well-being over time, remains crucial for understanding the potential onset of atrial fibrillation.

Know the Afib symptoms

Atrial fibrillation manifests through various symptoms such as fatigue, dizziness, chest pain, shortness of breath, and heart palpitations. Curiously, some individuals experience this condition without any noticeable signs.

Afib poses a threat, potentially paving the way for future issues. It aids blood clot formation and diminishes the heart’s pumping prowess. If neglected, it gradually undermines the heart’s strength, escalating the risk of stroke or heart failure.

Combatting Afib involves initial suggestions from physicians revolving around lifestyle modifications. These encompass adopting a heart-friendly diet, engaging in physical activity, shedding excess weight, and stress reduction, and moderating alcohol intake. Should lifestyle adjustments fall short, medication may be recommended by doctors from reliable care centers like the Advanced Cardiovascular Center in Goodyear.

Why would you get an irregular heartbeat after menopause?

Research conducted by the American Heart Association (AHA) has highlighted a noteworthy surge in heart disease risk among women after they hit menopause. According to the AHA, distinct shifts in sex hormone patterns and alterations in body composition, along with changes in fatty compounds known as lipids within the body, seem to be pivotal players in this scenario.

Dr. David Slotwiner, the head of cardiology at NewYork-Presbyterian Queens and an assistant professor involved in clinical medicine and population health sciences at Weill Cornell Medicine, emphasizes the direct impact of dwindling estrogen levels during menopause on the cardiovascular system. He elucidates that estrogen has a role in regulating the autonomic nervous system, which in turn governs heart rate and can influence heart rhythm. As estrogen levels plummet, some women may experience irregular heartbeats or sensations of their heart racing or fluttering, a distressing experience, particularly for those unaccustomed to such sensations, Dr. Slotwiner points out.

However, this study not only pinpoints menopause-related impacts but also underscores the significance of stress, both mental and physical, in triggering atrial fibrillation. The stress response, inclusive of hormonal activation and inflammation, directly impacts the cardiovascular system and also has repercussions on various other facets of health, such as sleep patterns, weight management, and alcohol consumption, all recognized atrial fibrillation risk factors.

The correlation between menopause and insomnia isn’t groundbreaking: Data from the National Institutes of Health (NIK) indicates that sleep disturbances like insomnia range from 16% to 42% before menopause, surging to 39% to 47% during perimenopause (the phase leading up to menopause), and reaching between 35% and 60% after menopause. Experts have theorized that shifting reproductive hormone levels, irregularities in the body’s internal clock, mood disorders, lifestyle choices, and other medical conditions might contribute to this.

Hormones are key players in sustaining a healthy and uninterrupted sleep cycle.

The AHA online resource also underscores that being an older adult poses a risk for atrial fibrillation, without explicitly citing menopause as a primary cause.

Lead researcher Dr. Susan X. Zhao, a cardiologist at Santa Clara Valley Medical Center in San Jose, CA., has observed in her patients that disrupted sleep patterns and negative emotions can heighten the likelihood of irregular heartbeats in postmenopausal women, even among those who seem to be in “top-notch physical condition.”

If you have attained menopause, get in touch with the doctors from the Advanced Cardiovascular Center in Goodyear to know whether you are at risk of developing Afib.

Limitations

The study’s got a catch, you know? They only checked folks’ mental and social stuff at the very start, just when everyone hopped in. But here’s the kicker: what if stress or how good you snooze shifted during the study, messing with the outcomes? Those smarty-pants researchers mentioned this snag.

Here’s another hitch: about 90% of the participants were white. So, it’s not possible to confirm if the same results go for other women from different racial or ethnic groups.

And wait, there’s more uncertainty! Does this scoop apply to younger gals who haven’t hit menopause yet? That’s a puzzle!

Treatment for AFib

Treatment options for atrial fibrillation can span a wide range. According to the American Heart Association, these can involve making shifts in your lifestyle, such as adopting a regular exercise routine and embracing a heart-friendly diet that slashes salt, saturated fats, trans fats, and cholesterol. Managing high blood pressure and cholesterol, maintaining a healthy weight, and curtailing excessive alcohol and caffeine intake are crucial aspects too.

However, addressing atrial fibrillation might necessitate medication or surgery. Get in touch with doctors at Advanced Cardiovascular Center in Goodyear to know your treatment options.

Beta-blockers, blood thinners, and calcium channel blockers could come into play to regulate your heart’s pace, restore its regular rhythm, and stave off blood clots. There’s also a procedure known as cardioversion, aimed at resetting the heart’s rhythm, especially during the first instance of atrial fibrillation. Surgery could become necessary if conventional medication and other treatments fall short.

Should you be experiencing symptoms of atrial fibrillation, reaching out to doctors from reputed cardiovascular centers like Advanced Cardiovascular Center in Goodyear is vital. They will answer your queries regarding irregular heartbeats, their duration, and other accompanying symptoms. Your doctor’s evaluation will pave the way for recommended steps forward from there.

References:

  1. https://pubmed.ncbi.nlm.nih.gov/37646212/ 
  2. https://pubmed.ncbi.nlm.nih.gov/15968015/