Cardiovascular Health, Physical Activity, and Outcomes in Women with Atrial Fibrillation
Description: Atrial fibrillation (AF) is a condition predominantly of older adults, affecting almost 20 million women in the United States, with increasing prevalence annually. While women with AF experience higher morbidity, mortality, and per-patient healthcare utilization rates compared to men with AF, they are underrepresented in studies on AF management and outcomes. Poor cardiovascular health, as defined by the American Heart Association’s Life’s Essential 8, is a measure of health factors and behaviors (unhealthy diet, minimal physical activity, tobacco use, inadequate sleep, high body mass index, elevated non-HDL cholesterol, high blood pressure, high blood glucose) known to be associated with incident AF, cardiovascular disease, and mortality in the general population. The impact of cardiovascular health on adverse health outcomes in individuals with AF has not been comprehensively evaluated, but may be accentuated in this population with an independently increased risk of incident cardiovascular disease. This project seeks to investigate if AF modifies the effect of (1) composite cardiovascular health and (2) a physical activity intervention on incident cardiovascular disease (myocardial infarction, stroke, heart failure, and cardiovascular mortality) among a cohort of older women. Using data from the Women’s Health Initiative (WHI), which includes a dataset of 161,808 women who were followed for over a decade, we will analyze the association between baseline, composite cardiovascular health score and incident cardiovascular disease, stratified by AF status. We will separately evaluate for an interaction between AF and the association between cardiovascular health and incident cardiovascular disease. Next, we will use data from the WHI Strong and Healthy trial, which randomized 49,331 WHI participants to a physical activity intervention informed by national recommendations or usual activity, to analyze the association between this physical activity intervention and cardiovascular disease by AF status. Ultimately, these findings will provide guidance to providers on prognostication of female AF patients based on cardiovascular health scores, and inform recommendations regarding lifestyle factors and physical activity among older, female patients with AF. As a result, this study will guide the allocation of public health resources in senior women and help identify targets for promoting longer, healthier lives among the vulnerable population of women with AF.
Funder: American Heart Association
Amount: $176,000
Funding type: fellowship
Funder scheme: Postdoctoral Fellowship
Start date: 2025-07-01
End date: 2027-11-01
Investigators: Sofia Gomez, Sofia Gomez
Institution: The Board of Trustees of the Leland Stanford Junior University
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Funded outputs count: 1
Funder award ID: 25POST1373600
OpenAlex ID: G853623037