Heart failure is a common cause of morbidity and mortality, despite progress made over the past 10 years, more than 6 million Americans live with heart failure, and over 900,000 new cases are diagnosed each year. There are known sex-based differences in risk factors, presentation and management of heart disease. A recent study sought to increase understanding of how sex differences relate to heart failure incidence, mortality, hospital admission and comorbidities (the presence of two chronic diseases).
Heart failure occurs when the heart muscles are unable to pump blood properly, conditions such as heart disease, high blood pressure, obesity and others can leave the heart weak or cause it to stiffen leading to failure. When the heart isn’t pumping blood as it should your body’s need for blood and oxygen isn’t being met causing various symptoms. Heart failure symptoms include shortness of breath, chronic cough/wheezing, fluid retention, fatigue, nausea or lack of appetite, impaired thinking, and high heart rate to name a few. Heart failure related to damage of the heart can’t be cured, but it can be treated to improve symptoms. This treatment may include life style changes, medications, implanted devices and surgical procedures. Life style changes may include losing/maintaining weight, avoiding caffeine and alcohol, managing stress, and being physically active.
A research group from the University of Ottawa Heart Institute recently published a study to examine the sex differences in heart failure. They followed patients 40 years of age and older (not including those over 105 years of age) who were newly diagnosed with heart failure in Ontario, Canada, between April 1, 2009 and March 31, 2014. Data collected included income, age, and comorbidities (dementia, depression, asthma, hypertension, etc.). Of the 90,000 patients followed 47% were female and more likely to be older, lower income, and have multiple chronic illnesses. After diagnosis, within one year of follow-up, 16.8% (7156) of women died compared with only 14.9% (7138) of men. Hospitalization rates for women were higher compared to men, in 2013 98 women per 1000 were hospitalized while 91 per 1000 men were hospitalized. The standardized age of mortality was also higher in women at 89 compared to 85 in men in 2009, while the age decreased throughout the study the age of women remained higher than men.
The study does have some limitations, first being the requirement of two claims of heart failure within one year, which can lead to underestimation of heart failure cases. The study also did not include analyses in subtypes of heart failure or examine cause-specific mortality, just all-cause mortality. Finally, the short period of observation and missing relevant details such as body mass index and smoking were not included. While these limitations were present the study was able to conclude, based on the data analyzed, heart failure remains high in women compared to men, with an increase in hospital admission for heart failure in women as well. Future studies will focus on sex difference in health-seeking behavior, medical therapy and response to therapy to help improve outcomes for women with heart failure.
To read this study click here, to learn more about the study watch the news report below!
Mayo Clinic, American Heart Association
