Connection between Atrial Fibrillation (AFib) and stress, as well as insomnia, following menopause?

Connection between Atrial Fibrillation (AFib) and stress, as well as insomnia, following menopause?

In a recent study, researchers have found a significant connection between psychosocial factors and the risk of developing atrial fibrillation (AFib) in women. The study, which analysed factors such as stress, insomnia, optimism, and social support, was conducted on a group of 83,736 postmenopausal women between the ages of 50 and 79.

The research revealed that there were 23,954 diagnoses of AFib in the group, with some participants experiencing multiple incidents. Dr. Sarina van der Zee, a cardiologist at Providence Saint John’s Health Center in California, discussed the study findings. She emphasized the importance of mental health evaluations in physical health examinations, suggesting that cardiologists should also ask about anxiety, stress, insomnia, and depression, as these are treatable conditions.

Atrial fibrillation primarily affects older adults and can lead to blood clots, stroke, heart failure, or cardiovascular complications. The study found that stress activates the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system, promoting systemic inflammation and vascular dysfunction, which contribute to the development and progression of cardiovascular diseases including AF.

Chronic psychological distress raises inflammatory markers like IL-6 and CRP, which are implicated in both psychiatric disorders and cardiovascular risk. Insomnia, which often co-occurs with stress and anxiety, disrupts autonomic balance and increases inflammation, further heightening cardiovascular risk.

Women with AF report lower quality of life and higher psychosocial burden, including stress and anxiety, which can exacerbate AF symptoms. Some evidence suggests women may be more vulnerable to certain psychosocial stressors, but recent studies indicate that gender differences in psychological stress burden among AF patients may not be as pronounced as once thought.

However, sex-specific factors such as high body mass index and blood pressure interact with psychosocial stress to influence overall AF risk in women. Exercise-based cardiac rehabilitation, which addresses psychosocial factors including stress and depression, can improve AF outcomes by reducing symptom severity and recurrence.

The development of atrial fibrillation was strongly linked to stressful life events and insomnia. For each additional point on the stressful life event scale, there was a 2% higher likelihood. For each additional point on the insomnia scale, there was a 4% higher likelihood of developing AFib.

According to a report published in 2022, women with AFib have a higher risk of stroke and treatment complications. By 2030, it is expected that more than 6 million Americans will develop AFib. Dr. Paul Drury, a cardiologist, stated that this is the first time the link between stress and AFib has been documented.

The study will encourage Dr. Drury to consider emotional drivers of AFib more in his practice. Women with AFib have a higher prevalence of hypertension and valvular heart disease and a lower prevalence of coronary heart disease than men. The findings of this study emphasize the importance of addressing psychosocial factors in the prevention and management of AFib, particularly in women.

1. The study also highlighted that chronic psychological distress raises inflammatory markers like IL-6 and CRP, which are implicated in both psychiatric disorders and cardiovascular risk.
2. The study found that stress activates the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system, promoting systemic inflammation and vascular dysfunction, which contribute to the development and progression of chronic diseases like atrial fibrillation.
3. The development of atrial fibrillation was strongly linked to stressful life events and insomnia, with each additional point on the stressful life event scale increasing the likelihood by 2% and each additional point on the insomnia scale increasing the likelihood by 4%.
4. Women with atrial fibrillation have a higher prevalence of hypertension and valvular heart disease and a lower prevalence of coronary heart disease than men, indicating that menopause and later life stages may interact with stress to influence overall atrial fibrillation risk.
5. Mental health evaluations are becoming increasingly important in physical health examinations, as cardiologists are urged to ask about anxiety, stress, insomnia, and depression, as these are treatable conditions that can impact cardiovascular health and fitness, sleep quality, and overall health and wellness.

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