Observational studyHeart (British Cardiac Society)2017
Menopausal age, postmenopausal hormone therapy and incident atrial fibrillation.
Observational study in Heart (British Cardiac Society), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Sex hormones and reproductive factors with cardiac arrhythmia and ECG indices: a mendelian randomization study.BMC cardiovascular disorders · 2024Pooled it
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Menopausal Age, Number of Live Births, and Risk of Atrial Fibrillation: The Cardiovascular Health Study.Journal of the American Heart Association · 2026Article
- Heart Failure and Atrial Fibrillation in Women: Pathophysiological Links, Clinical Challenges, and Therapeutic Perspectives.Medicina (Kaunas, Lithuania) · 2026Review
- [Russian eligibility criteria for prescription of menopausal hormone therapy to patients with cardiovascular and metabolic diseases. Agreement document of RKO, ROAG, RAE, EAT, AFR, RNMOT, RAGG].Problemy endokrinologii · 2026Article
- Hormonal Atrial Fibrillation: Pathophysiological Mechanisms That Trigger and Sustain the Arrhythmic Circuits.Biomedicines · 2025Review
- Unravelling Sex Disparities in the Pathophysiology of Atrial Fibrillation: Review of the Current Evidence.Journal of cardiovascular electrophysiology · 2025Review
- Mechanisms underlying atrial fibrillation in chronic kidney disease.Journal of molecular and cellular cardiology · 2025Review
- Menopausal Hormone Therapy and the Risk of Stroke: A Nationwide Cohort Study.Yonsei medical journal · 2025Article
- The role of estrogen in the sex difference for the risk factors of heart failure with preserved ejection fraction.Biology direct · 2025Review
- Global burden, temporal trends and geographic disparities of younger-onset atrial fibrillation in adults aged 30-45 years, 1990-2021: a population-based study.Frontiers in cardiovascular medicine · 2025Article
- Type of menopause, age of menopause and cardiovascular disease: a cross-sectional study based on data from Rafsanjan cohort study.BMC women's health · 2024Article
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024Article
- Article
- Age-Related Association between Sex and Postoperative Atrial Fibrillation in Non-Cardiac Surgery Patients: Observational Cohort Study.Reviews in cardiovascular medicine · 2023Article
- Position Statement on Ischemic Heart Disease - Women-Centered Health Care - 2023.Arquivos brasileiros de cardiologia · 2023Article
- Women Have More Recurrences of Atrial Fibrillation than Men after Thoracoscopic Ablation and Suffer More from Established Risk Factors.Journal of clinical medicine · 2023Article
- Arrhythmias in transgender individuals.Archivos de cardiologia de Mexico · 2023Article
- Connexin Lateralization Contributes to Male Susceptibility to Atrial Fibrillation.International journal of molecular sciences · 2022Article
- Association Between Sex-Specific Risk Factors and Risk of New-Onset Atrial Fibrillation Among Women.JAMA network open · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveLimited data exist on the association between menopause and atrial fibrillation (AF). We sought to examine the relationship between menopausal age, postmenopausal hormone therapy (PHT) use and incident AF.
methodsThe Women's Health Study (WHS) enrolled 39 876 female health professionals between 1992 and 1995. We prospectively examined 30 034 women in WHS using Cox proportional-hazard models. Participants were free of cardiovascular disease and AF at baseline and had not undergone hysterectomy without bilateral oophorectomy prior to menopause. Incident AF was confirmed by medical record review.
resultsAt baseline, median age was 53 years (IQR 49-60), median menopausal age was 50 years (IQR 46-52) and 14 415 (48.0%) had prior PHT use. Over a median follow-up of 20.5 years, 1350 AF events occurred. In multivariable analysis, relative hazards for AF were lower among women with younger age at menopause but did not differ significantly from women with the oldest menopausal age (<45: HR 0.82, 95% CI 0.67 to 1.02; 45-49: HR 0.90, 95% CI 0.74 to 1.08; 50-54: HR 0.89, 95% CI 0.75 to 1.06; >54 years: referent). Use of oestrogen-alone PHT, but not oestrogen and progesterone, was independently associated with AF risk (HR 1.22; 95% CI 1.02 to 1.45 vs HR 1.04; 95% CI 0.86 to 1.26). This relationship was not attenuated by intermediary cardiovascular events.
conclusionsIn this large prospective study, menopausal age was not significantly related to incident AF, while use of oestrogen monotherapy was associated with increased AF risk. Our findings suggest a pathophysiological link between unopposed oestrogen exposure and AF in women. CLINICAL
trial registrationNCT000000479; Post-results.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.