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December 10, 2003

Age and Sex as Independent Risk Factors for Stroke Among Patients With Atrial Fibrillation—Reply

JAMA. 2003;290(22):2937. doi:10.1001/jama.290.22.2937-a

To the Editor: Dr Wang and colleagues1 derived a risk score for predicting stroke and death in patients with new-onset atrial fibrillation (AF). The authors found that female sex decreased the 5-year risk of stroke. It is possible, however, that age may interact with sex in predicting risk. For example, Hart et al2 have reported that women with AF had a much higher rate of stroke compared with men among patients aged 75 years or older, but that there was no difference in risk among those younger than 75 years. Those authors concluded that this difference was due to differences in use of postmenopausal hormone therapy (HT). It is controversial whether HT really increases the risk of ischemic stroke.3 Thus, it remains uncertain whether female sex is a risk factor for stroke among women younger than 75 years.