Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and carries a large morbidity and mortality risk.¹ Evidence suggests differences in the pathophysiological processes of AF between men and women and an association of AF with a poor prognosis among women.^1,2 Such findings warrant additional research into the sex-specific risk factors in the development of AF.

To evaluate the relationship between depression and the risk of dementia. A real-world longitudinal study. This comprehensive study involved elderly adults in Yichang, China, who were dementia-free at baseline from 2016 to 2023. Participants were followed until the onset of all-cause dementia, Alzheimer's disease, vascular dementia and unspecified dementia until December 31, 2023. Depression was identified using the International Classification of Diseases, 10th Revision codes, based on linked electronic health records. Multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CI) from the Cox proportional hazards regression models to evaluate the risks of all-cause dementia and its subtypes associated with prevalent depression. During an average follow-up of 3.63 years, we observed a total of 1 493 individuals developing dementia among 4 341 depressed and 43 214 matched non-depressed individuals (62.4% female; mean [SD] age at baseline 64.4 [11.1] years). Notably, a stronger association was observed between depression and the onset of Alzheimer's disease (adjusted HR, 4.96; 95% CI, 2.95-8.34) compared to vascular dementia (adjusted HR, 1.92; 95% CI, 1.18-3.11). Moreover, our study intriguingly revealed a U-shaped association between the risk of Alzheimer's disease and the duration of time an individual has been diagnosed with depression. Our findings unveil a significant association between depression and all-cause dementia, Alzheimer's disease and vascular dementia. The unique temporal association suggests that depression may serve as both a risk factor and a prodromal symptom for Alzheimer's disease, and solely as a risk factor for vascular dementia.

To assess the sex-specific evolution of various anthropometric measures and the association of their longitudinal trajectories with new-onset atrial fibrillation (AF). Among 5266 men and 7218 women free of AF at baseline from the prospective population-based Rotterdam Study, each anthropometric measure was measured 1 to 5 times from 1989 to 2014. Anthropometric measures were standardized to obtain hazard ratios per 1 SD increase to enable comparison. Joint models were used to assess the longitudinal association between anthropometric measures and incident AF. Use of the joint models is a preferred method for simultaneous analyses of repeated measurements and survival data for conferring less biased estimates. Mean (SD) age was 63.9 (8.9) years for men and 64.9 (9.8) years for women. Median follow-up time was 10.5 years. Longitudinal evolution of weight, height, waist circumference, hip circumference, and body mass index was associated with an increased risk of new-onset AF in both men and women. In joint models, larger height in men (hazard ratio [95% credible interval] per 1 SD, 1.27 [1.17 to 1.38]) and weight in women (1.24 [1.16 to 1.34]) showed the largest associations with AF. In joint models, waist to hip ratio was significantly associated with incident AF only in women (1.10 [1.03 to 1.18]). Considering the entire longitudinal trajectories in joint models, anthropometric measures were positively associated with an increased risk for new-onset AF among men and women in the general population. Increase in measure of central obesity showed a stronger association with increased risk of AF onset among women compared with men.

Background: Water, coffee and tea are the primary sources of daily hydration. However, the sex-specific relationship between these beverages and cardiovascular disease (CVD) among remains unclear.Methods: In total, 210,239 men and 251,383 women from the UK Biobank were included. The consumption of water, coffee and tea were self-reported. CVDs, including coronary heart disease (CHD), stroke and heart failure (HF) were followed till March 1st, 2023. Sex-specific Cox models were utilized to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations.Results: During a median follow-up of 8.7 years, 11,098 (2.40%) participants developed new-onset HF, 33,426 (7.24%) participants developed new-onset CHD, and 9,706 (2.10%) participants developed new-onset stroke. After adjustments, higher water consumption was generally associated with reduced risk of CVDs among both men and women. In contrast, heavy coffee consumption (particularly ≥6 cups/day) was associated with a greater risk of HF [1.16 (1.03–1.31) in men vs. 1.25 (1.12–1.40) in women], a greater risk of CHD [1.27 (1.18–1.36) in men vs. 1.21 (1.14–1.29) in women] and a greater risk of stroke [1.13 (0.99–1.29) in men vs. 1.20 (1.03–1.31) in women]. Similarly, heavy tea consumption was associated with an increased risk of HF (men: HR 1.19 [1.08–1.31]; women: HR 1.12 [1.02–1.23]) and CHD (men: HR 1.12 [1.05–1.18]; women: HR 1.18 [1.12–1.24]).Conclusion: Our study revealed that water consumption was associated with a lower risk of CVDs, with a lower risk of CVDs, while heavy coffee or tea consumption was linked to a higher risk. Notably, coffee and tea consumption partially attenuated the protective association of water intake with CVDs. Furthermore, significant sex differences were observed in the associations between coffee or tea consumption and CHD incidence.

Background: Sarcopenia is associated with cardiovascular diseases (CVDs). However, whether changes in sarcopenia status affect CVD risk remains unclear. In addition, how indoor fuel use impacts the sarcopenia transition process is less well studied. Objective: This study prospectively examined the association of sarcopenia transitions with CVD risk, while exploring the effect of indoor fuel on these transitions. Methods: In this prospective observational study, we used data from the China Health and Retirement Longitudinal Study waves 1 to 4 (2011 to 2018). In total, 8739 participants with complete data on sarcopenia and indoor fuel use were included for the indoor fuel use and sarcopenia transition analysis, and 6385 participants without previous CVDs were included for the sarcopenia transition and CVD risk analysis. Sarcopenia transition was defined according to the sarcopenia status at wave 1 (2011) and wave 2 (2013). Incident CVDs included heart diseases, stroke, and composite CVDs. Information on indoor fuel use was obtained at wave 1. Cox proportional hazards models were used to examine the effect of sarcopenia transition on incident CVDs. Logistic regression models were used to investigate the impact of indoor fuel use on these transitions. Results: During a median of 7.0 years of follow-up, 1233 incident CVDs were documented. Compared to stably normal participants, progressing from a normal state to possible or confirmed sarcopenia brought increased risk of incident CVD (hazard ratio 1.42, 95% CI 1.15-1.77). Conversely, recovering to a normal state was associated with decreased risk (hazard ratio 0.72, 95% CI 0.55-0.95) for baseline participants with possible sarcopenia. In addition, clean fuel use increased the odds of achieving a possible-to-normal transformation (odds ratio 1.32, 95% CI 1.06-1.64), while both solid cooking and heating fuel use were associated with a higher risk of deterioration in sarcopenia status. Conclusions: An unfavorable transition in sarcopenia status is associated with higher CVD risk, while reversion from possible sarcopenia to a normal state could reduce the risk. Therefore, early intervention for sarcopenia is imperative for CVD prevention, and promoting clean indoor fuel use is recommended.