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.
Kida Y. 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
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