Bamgbade BA, McManus DD, Helm R, et al. - More than two-thirds of patients with atrial fibrillation on oral anticoagulant therapy underestimated their bleeding risk, and participants with a history of bleeding and multiple comorbid conditions were more likely to underestimate their bleeding risk, whereas non-Whites and women were less likely to underestimate their bleeding risk. Clinicians should make sure that patients who are receiving oral anticoagulant therapy understand the risks of bleeding.

• The authors compared patients’ self‐reported bleeding risk with their predicted bleeding risk from their HAS‐BLED score in the SAGE‐AF (Systematic Assessment of Geriatric Elements in Atrial Fibrillation) study, a prospective cohort study of patients ≥ 65 years with atrial fibrillation, a CHA₂DS₂‐VASc risk score ≥ 2, and who were on oral anticoagulant therapy.

• Data reported that 68.0% of the 754 individuals (mean age 74.8 years, 48.3% women) underestimated their bleeding risk.

• Asian or Pacific Islander participants, Black, Native American or Alaskan Native participants, Mixed Race or Hispanic (non-White) participants and women had considerably lower odds of underestimating their bleeding risk than the comparison groups.

• Participants who had a history of bleeding and had previously experienced hypertension, stroke, or renal disease were more likely to underestimate their bleeding risk.