Association of sex hormones, aging, and atrial fibrillation in men: the Framingham Heart Study.

Published

Journal Article

BACKGROUND: Endogenous sex hormones have been related to cardiovascular outcomes and mortality. We hypothesized that sex hormones are related to atrial fibrillation (AF) in a community-based cohort of middle-aged to older men. METHODS AND RESULTS: We examined testosterone, estradiol, and dehydroepiandrosterone sulfate in relation to incident AF in men participating in the Framingham Heart Study. We assessed the 10-year risk of AF in multivariable-adjusted hazard models. The cohort consisted of 1251 men (age, 68.0±8.2 years), of whom 275 developed incident AF. We identified a significant interaction between age and testosterone and, therefore, stratified men into age 55 to 69 years (n=786), 70 to 79 years (n=351), and ≥80 years (n=114). In men aged 55 to 69 years, each 1 SD decrease in testosterone was associated with hazard ratio (HR) 1.30 (95% confidence interval [CI], 1.07-1.59) for incident AF. The association between testosterone and 10-year incident AF in men 70 to 79 years did not reach statistical significance. In men≥80 years, a 1 SD decrease in testosterone was associated with HR 3.53 (95% CI, 1.96-6.37) for AF risk. Estradiol was associated with incident AF (HR, 1.12; 95% CI, 1.01-1.26). Dehydroepiandrosterone sulfate had a borderline association with risk of AF that was not statistically significant (HR, 1.12; 95% CI, 0.99-1.28). CONCLUSIONS: Testosterone and estradiol are associated with incident AF in a cohort of older men. Testosterone deficiency in men≥80 years is strongly associated with AF risk. The clinical and electrophysiological mechanisms underlying the associations between sex hormones and AF in older men merit continued investigation.

Full Text

Duke Authors

Cited Authors

  • Magnani, JW; Moser, CB; Murabito, JM; Sullivan, LM; Wang, N; Ellinor, PT; Vasan, RS; Benjamin, EJ; Coviello, AD

Published Date

  • April 2014

Published In

Volume / Issue

  • 7 / 2

Start / End Page

  • 307 - 312

PubMed ID

  • 24610804

Pubmed Central ID

  • 24610804

Electronic International Standard Serial Number (EISSN)

  • 1941-3084

Digital Object Identifier (DOI)

  • 10.1161/CIRCEP.113.001322

Language

  • eng

Conference Location

  • United States