Serial 7-Day Electrocardiogram Patch Screening for AF in High-Risk Older Women by the CHARGE-AF Score.

BACKGROUND: Asymptomatic atrial fibrillation (AF) is associated with an increased risk of stroke. The yield of serial electrocardiographic (ECG) screening for AF is unknown. OBJECTIVES: The aim of this study was to determine the frequency of AF detected by serial, 7-day ECG patch screenings in older women identified as having an elevated risk of AF according to the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology)-AF clinical prediction score. METHODS: Postmenopausal women with a 5-year predicted risk of new-onset AF ≥5% according to CHARGE-AF were recruited from the ongoing WHISH (Women's Health Initiative Strong and Healthy) randomized trial of a physical activity intervention. Participants with AF at baseline by self-report or medical records review were excluded. Screening with 7-day ECG patch monitors was performed at baseline, 6 months, and 12 months from study enrollment. RESULTS: On baseline monitoring, 2.5% of the cohort had AF detected, increasing to 3.7% by 6 months and 4.9% cumulatively by 12 months. Yield of patch screening was higher among participants with a higher (≥10%) CHARGE-AF score: 4.2% had AF detected at baseline, 5.9% at 6 months, and 7.2% at 12 months. Most participants with patch-identified AF never had a clinical diagnosis of AF (36 of 46 [78%]). CONCLUSIONS: Older women with an elevated CHARGE-AF score had a high prevalence of AF on 7-day ECG patch screening. Serial screening over 12 months substantially increased the detection of AF. These data can be useful in helping identify high-risk participants for enrollment in future studies of the management of asymptomatic AF.(Women's Health Initiative Silent Atrial Fibrillation Recording Study [WHISH STAR]; NCT05366803.).

Blood pressure control and glaucoma risk in postmenopausal women: an analysis from the Women's Health Initiative.

OBJECTIVE: Individuals with elevated systolic blood pressure (BP) or low diastolic BP, whether or not on antihypertensive treatment, may be at higher risk for developing glaucoma. We aimed to investigate BP levels in relation to glaucoma risk in a large cohort of postmenopausal women. METHODS: Prospective follow-up of 101,447 postmenopausal women without prior history of glaucoma enrolled in the Women's Health Initiative Study. BP was measured in-clinic at baseline and after 3 years using standardized procedures. Antihypertensive medication use was determined by drug inventory at baseline and year 3. Women self-reported incident newly diagnosed glaucoma annually. Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazards analyses adjusting for demographic, medical history, and lifestyle covariates. RESULTS: During a mean follow-up of 4.7 years, we documented 7,514 glaucoma cases. Among women not on antihypertensive treatment, those with systolic BP ≥ 140 mm Hg or diastolic BP ≥80 mm Hg were not at higher risk of developing glaucoma (HR 0.97, 95% confidence intervals 0.88-1.08 and HR 1.00 [0.93-1.08], respectively), compared with women with a systolic BP < 120 mm Hg or a diastolic BP 60 to <80 mm Hg. Among women on antihypertensive treatment, neither systolic BP ≥ 140 mm Hg nor diastolic BP ≥80 mm Hg was associated with an increased glaucoma risk (HR 0.89 [0.79-1.00] and HR 0.97 [0.90-1.05], respectively). A diastolic BP <60 mm Hg was not associated with a higher risk compared with a diastolic BP 60 to <80 mm Hg. CONCLUSIONS: BP control is not associated with an increased or decreased glaucoma risk in postmenopausal women.