Gender-related differences in clinical profile and outcome of patients with heart failure. Results of the RICA Registry

Conde‐Martel, Alicia; Arkuch, M.E.; Formiga, F.; Manzano-Espinosa, Luis; Aramburu‐Bodas, Óscar; González-Franco, Álvaro; Dávila‐Ramos, Melitón Francisco; Suárez-Pedreira, Iván; Herrero-Domingo, A.; Montero-Pérez-Barquero, Manuel

doi:10.1016/j.rceng.2015.03.003

Cited by 18 publications

(42 citation statements)

References 33 publications

(57 reference statements)

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“…Regarding the length of hospital stay, we did not found differences between sexes, as previously reported …”

Section: Discussionsupporting

confidence: 83%

“…Similarly, as previously published, the present results were in accordance to other HF studies assessing differences between sex, in which women on their first admission for HF are usually older, with hypertensive rather than ischemic etiology . Unfortunately, as not all of our included patients had systematic echocardiographic study carried out on admission, we could not confirm the reported predominance of preserved HF in women .…”

Section: Discussionsupporting

confidence: 82%

“…In contrast, men with a first hospitalization due to HF presented with a higher percentage of chronic obstructive pulmonary disease and chronic kidney disease as comorbidities, as well as stroke and a higher mean CCI score, as it has also been reported . This last finding of increased overall comorbidity in men with HF has also been reported by Conde‐Martel et al …”

Section: Discussionsupporting

confidence: 73%

“…With the aging of the population, the impact of heart failure (HF) is increasing, with a greater proportion of women in this oldest age range group …”

Section: Introductionmentioning

confidence: 99%

“…Compared with men, women with HF have been reported to often be older, more likely to have preserved ejection fraction, more likely to have a hypertensive etiology and show a different comorbidity profile . Some studies have also reported that HF mortality rates are higher in men than in women .…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Formiga

Moreno-González

Chivite

et al. 2018

Geriatrics Gerontology Int

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Aim To assess whether 1‐year mortality in older patients experiencing a first admission for acute heart failure was related to sex, and to explore differential characteristics according to sex. Methods We reviewed the medical records of 1132 patients aged >70 years of age admitted within a 3‐year period because of a first episode of acute heart failure. We analyzed sex differences. Mortality was assessed using multivariate Cox analysis. Results There were 648 (57.2%) women (mean age 82.1 years) and 484 men (mean age 80.1 years). There were some differences in risk factors: women more often had hypertension, and less frequently had coronary heart disease and comorbidities (women more often had dementia, and men more often had chronic obstructive pulmonary disease, chronic kidney disease and stroke). Women were treated more frequently with spironolactone. The 1‐year all‐cause mortality rate was 30.2% (30.7% women and 29.5% men). Multivariate Cox analysis identified an association between reduced heart failure (hazard ratio [HR] 0.35, 95% confidence interval [95% CI] 0.21–0.59), hemoglobin <10 g/dL (HR 1.99, 95% CI 1.16–3.40), systolic blood pressure (HR 0.98, 95% CI 0.97–0.99), previous diagnosis of dementia (HR 2.07, 95% CI 1.12–3.85), number of chronic therapies (HR 1.12, 95% CI 1.05–1.19) and 1‐year mortality in women. In men, an association with mortality was found for low systolic blood pressure (HR 0.97, 95% CI 0.97–0.98) and higher potassium values (HR 1.42, 95% CI 1.01–2.00). Conclusions Among older patients hospitalized for the first acute heart failure episode, there is a slightly higher predominance of women. There are sex differences in risk factors and comorbidities. Although the mortality rate is similar, the factors associated with it according to sex are different. Geriatr Gerontol Int 2019; 19: 184–188.

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“…Regarding the length of hospital stay, we did not found differences between sexes, as previously reported …”

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 73%

“…With the aging of the population, the impact of heart failure (HF) is increasing, with a greater proportion of women in this oldest age range group …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Formiga

Moreno-González

Chivite

et al. 2018

Geriatrics Gerontology Int

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Sex‐ and age‐related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long‐Term Registry

Lainščak

Milinković

Polovina

et al. 2019

European J of Heart Fail

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AimsThis study aimed to assess age-and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients.Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All-cause mortality and all-cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1-year all-cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years.

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Comorbidities in Heart Failure: Are There Gender Differences?

Hopper

Kotecha

Chin

et al. 2016

Curr Heart Fail Rep

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Compared to men, women with heart failure (HF) are often older, smoke less, and have more preserved ejection fraction (EF) and hypertensive HF rather than HF of ischemic etiology. Gender-stratified outcomes on comorbidities data in HF are scarce. Women have traditionally been underrepresented in HF trials. Although data suggest that overall prognosis may be better in women, they experience lower quality of life with greater functional impairment from HF compared to men. Gender differences have been reported for comorbid diabetes, chronic obstructive pulmonary disease, renal dysfunction, anemia, and depression and may explain gender disparity in outcomes. However, possible confounding of comorbidities with known prognostic determinants in HF (such as EF) as well as gender differences in the utilization of medical therapies obscures interpretation. In this review, we will explore the evidence for gender differences in non-cardiovascular comorbidities in HF. Our findings may guide clinicians to individualize HF care, according to best practice, in the hope of improving prognosis for this chronic and debilitating condition.

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Gender-related differences in clinical profile and outcome of patients with heart failure. Results of the RICA Registry

Cited by 18 publications

References 33 publications

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Sex differences in 1‐year mortality risks in older patients experiencing a first acute heart failure hospitalization

Sex‐ and age‐related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long‐Term Registry

Comorbidities in Heart Failure: Are There Gender Differences?

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