Sex differences in the association of risk factors for heart failure incidence and mortality

Ho, Frederick K.; Pell, Gill P; Gill, Jason M. R.; Sattar, Naveed; Gray, Stuart R.; Celis‐Morales, Carlos

doi:10.1136/heartjnl-2019-314878

Cited by 25 publications

(36 citation statements)

References 27 publications

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“…Previous research has shown that there are differences in the onset and impact of cardiovascular disease and HF according to gender [ 18 , 19 , 20 , 21 ]. Male gender is an independent cardiovascular risk factor and determines that cardiovascular disease develops at a younger age.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

Garay

Tapia

Anguita³

et al. 2020

JCM

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Previous studies have shown that heart failure is associated with worse health-related quality of life (HRQoL). The existence of differences according to gender remains controversial. We studied 1028 consecutive outpatients with heart failure and reduced ejection fraction (HFrEF) from a multicentre cross-sectional descriptive study across Spain that assessed HRQoL using two questionnaires (KCCQ, Kansas City Cardiomyopathy Questionnaire; and EQ-5D, EuroQoL 5 dimensions). The primary objective of the study was to describe differences in HRQoL between men and women in global scores and domains of health status of patients and explore gender differences and its interactions with heart failure related factors. In adjusted analysis women had lower scores in KCCQ overall summary scores when compared to men denoting worse HRQoL (54.7 ± 1.3 vs. 62.7 ± 0.8, p < 0.0001), and specifically got lower score in domains of symptom frequency, symptoms burden, physical limitation, quality of life and social limitation. No differences were found in domains of symptom stability and self-efficacy. Women also had lower scores on all items of EQ-5D (EQ-5D index 0.58 ± 0.01 vs. 0.67 ± 0.01, p < 0.0001). Finally, we analyzed interaction between gender and different clinical determinants regarding the presence of limitations in the 5Q-5D and overall summary score of KCCQ. Interestingly, there was no statistical significance for interaction for any variable. In conclusion, women with HFrEF have worse HRQoL compared to men. These differences do not appear to be mediated by clinical or biological factors classically associated with HRQoL nor with heart failure severity.

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Section: Discussionmentioning

confidence: 99%

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

Garay

Tapia

Anguita³

et al. 2020

JCM

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“…The correlation between gender and heart failure is much stronger in women than in men. This correlation leads to increased heart failure and, therefore, more digoxin use in women (13). The fact that valve diseases and rhythm disorders are more common in women (14) and that mortality occurs at a later age compared to men may cause digoxin use to appear relatively higher in women.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Digoxin Levels in Elderly Patients in a Training Hospital: An 11-Year Follow-Up

Yılmaz¹,

Bilgili²,

Bozkaya³

2020

tjgeri

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Introduction: Digoxin monitoring is important in the elderly because of the toxicity risk. The aim of this study was to evaluate the orders made by different units for digoxin monitoring in the elderly. Materials and Method: Digoxin orders and results in patients aged over 65, patients' demographic characteristics, such as age and gender, the unit from which the order was made, and patients' pre-diagnoses were retrospectively recorded. Patients were divided into young-old, middle-old, and very-old groups, and the results were divided into subtherapeutic, therapeutic, and toxic levels. Results: The percentage of young-old, middle-old, and very-old patients was 39.4%, 45.3%, and 15.3%, respectively. Women were more (64.3%) and their median age and digoxin concentrations were higher (p<0.001). Outpatients' median digoxin concentrations were lower than inpatients' median digoxin concentrations (p<0.001). A proportion of 46.6% of all digoxin levels were therapeutic; 29.2% were subtherapeutic; and 24.2% were toxic. Subtherapeutic levels in males and toxic levels in females predominated (p<0.001). Toxic levels were higher in inpatients, and subtherapeutic levels were higher in outpatients (p<0.001). The highest rate of therapeutic levels was observed in young-old patients (48.7%), while toxic levels were observed most frequently in very-old patients (28.1%). The highest number of digoxin orders in elderly patients was from the emergency department (44.2%). Conclusion: In elderly patients, more than half of the serum digoxin orders were inappropriate. These results significantly changed according to gender, outpatient or inpatient status, age, and the ordering unit. Changes in digoxin pharmacokinetics, especially in the geriatric period, require physicians to be vigilant of subtherapeutic drug concentrations.

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“…The University of Glasgow has expertise on vascular neurological and cardiometabolic diseases [28][29][30]. The primary source of data is the UK Biobank, which recruited 502,536 participants, aged 39-72 years, from the general population between 2007 and 2010.…”

Section: University Of Glasgow Ukmentioning

confidence: 99%

Application of Healthcare ‘Big Data’ in CNS Drug Research: The Example of the Neurological and mental health Global Epidemiology Network (NeuroGEN)

et al. 2020

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Neurological and psychiatric (mental health) disorders have a large impact on health burden globally. Cognitive disorders (including dementia) and stroke are leading causes of disability. Mental health disorders, including depression, contribute up to one-third of total years lived with disability. The Neurological and mental health Global Epidemiology Network (NeuroGEN) is an international multi-database network that harnesses administrative and electronic medical records from Australia, Asia, Europe and North America. Using these databases NeuroGEN will investigate medication use and health outcomes in neurological and mental health disorders. A key objective of NeuroGEN is to facilitate high-quality observational studies to address evidence-practice gaps where randomized controlled trials do not provide sufficient information on medication benefits and risks that is specific to vulnerable population groups. International multi-database research facilitates comparisons across geographical areas and jurisdictions, increases statistical power to investigate small subpopulations or rare outcomes, permits early post-approval assessment of safety and effectiveness, and increases generalisability of results. Through bringing together international researchers in pharmacoepidemiology, NeuroGEN has the potential to be paradigmchanging for observational research to inform evidence-based prescribing. The first focus of NeuroGEN will be to address evidence-gaps in the treatment of chronic comorbidities in people with dementia.

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Sex differences in the association of risk factors for heart failure incidence and mortality

Cited by 25 publications

References 27 publications

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

Evaluation of Digoxin Levels in Elderly Patients in a Training Hospital: An 11-Year Follow-Up

Application of Healthcare ‘Big Data’ in CNS Drug Research: The Example of the Neurological and mental health Global Epidemiology Network (NeuroGEN)

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