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Early or delayed menopause and irregular periods tied to new-onset atrial fibrillation




  • Early or delayed menopause and a history of irregular menstrual cycles were significantly associated with a greater risk of new-onset atrial fibrillation (AF) in women.
  • Women with nulliparity and multiparity had a greater risk of new-onset AF compared with those with one to two live births.

Why this matters

  • Findings highlight the significance of considering the reproductive history of women while developing tailored screening and prevention strategies for AF.

Study design

  • A population-based cohort study of 235,191 women (age, 40-69 years) without AF and a history of hysterectomy and/or bilateral oophorectomy, identified from the UK Biobank (2006-2010).
  • Funding: Gender and Prevention Grant from ZonMw and other.

Key results

  • During a median follow-up of 11.6 years, 4,629 (2.0%) women were diagnosed with new-onset AF.
  • A history of irregular menstrual cycle was associated with higher risk of new-onset AF (adjusted HR, 1.34; 95% confidence interval, 1.01-1.79; P = .04).
  • Compared with women who experienced menarche at the age of 12 years, the risk of new-onset AF was significantly higher in those who experienced menarche:
  • –Earlier between the ages of 7 and 11 years (aHR, 1.10; 95% CI, 1.00-1.21; P = .04) and
  • –Later between the ages of 13 and 18 years (aHR, 1.08; 95% CI, 1.00-1.17; P = .05).
  • The risk of new-onset AF was significantly higher in women who experienced menopause:
  • –At the age of < 35 years (aHR, 2.25; 95% CI, 1.48-3.43; P < .001);
  • –Between the ages of 35 and 44 years (aHR, 1.24; 95% CI, 1.10-1.39; P < .001); and
  • –At the age of ≥ 60 years (aHR, 1.34; 95% CI, 1.10-1.78; P = .04).
  • Women with no live births (aHR, 1.13; 95% CI, 1.04-1.24; P < .01), four to six live births (aHR, 1.12; 95% CI, 1.01-1.24; P = .04), and ≥ seven live births (aHR, 1.67; 95% CI, 1.03-2.70; P = .03) vs. those with one to two live births had a significantly higher risk of new-onset AF.


  • Observational design.

A version of this article first appeared on Medscape UK.


Lu Z, Aribas E, Geurts S, Roeters van Lennep JE, Ikram MA, Bos MM, de Groot NMS, Kavousi M. Association Between Sex-Specific Risk Factors and Risk of New-Onset Atrial Fibrillation Among Women. JAMA Netw Open. 2022;5(9):e2229716. doi: 10.1001/jamanetworkopen.2022.29716. PMID: 36048441.

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