ArticleJournal of the American Heart Association2023
Association Between Insomnia, Stress Events, and Other Psychosocial Factors and Incident Atrial Fibrillation in Postmenopausal Women: Insights From the Women's Health Initiative.
Article in Journal of the American Heart Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.
- Social relationships and risk of cardio-cerebrovascular diseases: a meta-analysis of longitudinal cohort studies.Social psychiatry and psychiatric epidemiology · 2026Pooled it
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Mental Health Across the Atrial Fibrillation Continuum: Mechanisms, Outcomes, and Clinical Implications.Life (Basel, Switzerland) · 2026Review
- [The role of psychosocial risk factors in the development and course of atrial fibrillation].Herzschrittmachertherapie & Elektrophysiologie · 2026Review
- Income Insufficiency, Type 2 Diabetes, and Perceived Stress in Cardiac Arrhythmia Outpatients: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Sleep Disruption and Atrial Fibrillation: Evidence, Mechanisms and Clinical Implications.Circulation research · 2025Review
- Neurocognitive and Psychosocial Interactions in Atrial Fibrillation: Toward a Holistic Model of Care.Healthcare (Basel, Switzerland) · 2025Article
- Depression, Anxiety, and Stress Symptoms (DASS-21) in Elderly Women in Association with Health Status (SHSQ-25): A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Review
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024Article
Corrections and comments
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Authors and funding
10 authors at 9 institutions in 1 country.
Funding
Abstract
Background The association between psychosocial factors and atrial fibrillation (AF) is poorly understood. Methods and Results Postmenopausal women from the Women's Health Initiative were retrospectively analyzed to identify incident AF in relation to a panel of validated psychosocial exposure variables, as assessed by multivariable Cox proportional hazard regression and hierarchical cluster analysis. Among the 83 736 women included, the average age was 63.9±7.0 years. Over an average of 10.5±6.2 years follow-up, there were 23 954 cases of incident AF. Hierarchical cluster analysis generated 2 clusters of highly correlated psychosocial variables: the Stress Cluster included stressful life events, depressive symptoms, and insomnia, and the Strain Cluster included optimism, social support, social strain, cynical hostility, and emotional expressiveness. Incident AF was associated with higher values in the Stress Cluster (hazard ratio [HR], 1.07 per unit cluster score [95% CI, 1.05-1.09]) and the Strain Cluster (HR, 1.03 per unit cluster score [95% CI, 1.00-1.05]). Of the 8 individual psychosocial predictors that were tested, insomnia (HR, 1.04 [95% CI, 1.03-1.06]) and stressful life events (HR, 1.02 [95% CI, 1.01-1.04]) were most strongly associated with increased incidence of AF in Cox regression analysis after multivariate adjustment. Subgroup analyses showed that the Strain Cluster was more strongly associated with incident AF in those with lower traditional AF risks (
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