Volume 4, Issue 2 (April 2025)
Health Science Monitor 2025, 4(2): 92-102 |
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Hajahmadi Pourrafsanjani M, Afsargharehbagh R, Rostamzadeh A, Mirabi Ahar Nejani M, Rahimi B. Gender-related differences in manifestations, complications, and mortality rate of systolic heart failure patients. Health Science Monitor 2025; 4 (2) :92-102
URL: http://hsm.umsu.ac.ir/article-1-203-en.html
URL: http://hsm.umsu.ac.ir/article-1-203-en.html
Mojgan Hajahmadi Pourrafsanjani 
, Roghaiyeh Afsargharehbagh , Alireza Rostamzadeh * , Mahsa Mirabi Ahar Nejani , Behzad Rahimi
, Roghaiyeh Afsargharehbagh , Alireza Rostamzadeh * , Mahsa Mirabi Ahar Nejani , Behzad Rahimi
Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
Abstract: (194 Views)
Background & Aims: Cardiovascular diseases (CVD) are one of the leading causes of death worldwide. Important differences in comorbidities and clinical characteristics exist between women and men with heart failure. This study aimed to explore the influence of gender on the clinical manifestations, complications, and mortality of patients with systolic heart failure.
Materials & Methods: In this cross-sectional study, medical records of all patients who were hospitalized with heart failure between September 2020 and September 2022 were examined. The study gathered information on demographic characteristics, coronary risk factors, clinical symptoms, pathological features, use of selected drugs, and other comorbidities.
Results: Of 1340 patients, 67.2% were men and 32.8% were women with a mean age of 70.58 ± 14.34 years. Fifty-seven (4.2%) patients had the first New York Heart Association (NYHA) class, 120 (8.9%) had the second, 341 (25.5%) had the third, and 161 (12.01%) patients had the fourth NYHA class. The mortality rate and mean ejection fraction (EF) were high in women (9.73%, 35 ± 13.27, respectively). The men had a higher glomerular filtration rate (GFR) (50.45 ± 15.43) than women (40.68 ± 13.98), which was significant (p = 0.01). The history of hypertension and myocardial infarction (MI) was high in men (86.36% and 33%, respectively) which were significant (p = 0.02, p = 0.005, respectively). No gender differences were found in laboratory findings (p ˂ 0.05). The consumption of drugs was more common in women than in men; therefore, it was not statistically significant (p < 0.05).
Conclusion: This study revealed that women have a significantly higher mean age and EF, drug consumption, and hospital mortality rate compared to men. Otherwise, men have a significantly higher history of hypertension, NYHU function class, and ischemic heart disease.
Materials & Methods: In this cross-sectional study, medical records of all patients who were hospitalized with heart failure between September 2020 and September 2022 were examined. The study gathered information on demographic characteristics, coronary risk factors, clinical symptoms, pathological features, use of selected drugs, and other comorbidities.
Results: Of 1340 patients, 67.2% were men and 32.8% were women with a mean age of 70.58 ± 14.34 years. Fifty-seven (4.2%) patients had the first New York Heart Association (NYHA) class, 120 (8.9%) had the second, 341 (25.5%) had the third, and 161 (12.01%) patients had the fourth NYHA class. The mortality rate and mean ejection fraction (EF) were high in women (9.73%, 35 ± 13.27, respectively). The men had a higher glomerular filtration rate (GFR) (50.45 ± 15.43) than women (40.68 ± 13.98), which was significant (p = 0.01). The history of hypertension and myocardial infarction (MI) was high in men (86.36% and 33%, respectively) which were significant (p = 0.02, p = 0.005, respectively). No gender differences were found in laboratory findings (p ˂ 0.05). The consumption of drugs was more common in women than in men; therefore, it was not statistically significant (p < 0.05).
Conclusion: This study revealed that women have a significantly higher mean age and EF, drug consumption, and hospital mortality rate compared to men. Otherwise, men have a significantly higher history of hypertension, NYHU function class, and ischemic heart disease.
Type of Study: Research |
Subject:
Special
Received: 2024/10/8 | Accepted: 2025/02/16 | Published: 2025/04/30
Received: 2024/10/8 | Accepted: 2025/02/16 | Published: 2025/04/30
References
1. Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro MG, Harjola VP, et al. Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry Methods and results. European Journal of Heart Failure. 2017:1-12.
https://doi.org/10.1002/ejhf.813 [DOI] [PMID]
2. Dini FL, Pugliese NR, Ameri P, Attanasio U, Badagliacca R, Correale M, et al. Right ventricular failure in left heart disease: from pathophysiology to clinical manifestations and prognosis. Heart Failure Reviews. 2023;28(4):757-66. doi: 10.1007/s10741-022-10282-2. [DOI] [PMID] [PMCID]
3. Groenewegen A, Rutten FH, Mosterd A, Hoes AW. Epidemiology of heart failure. European journal of heart failure. 2020;22(8):1342-56. doi: 10.1002/ejhf.1858. [DOI] [PMID] [PMCID]
4. Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Cardiac Failure Review. 2017;3(1):7-11. doi: 10.15420/cfr.2016:25:2. [DOI] [PMID]
5. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the Management of Heart Failure: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the heart failure Society of Amer. Circulation. 2017;136:e137- 61.
https://doi.org/10.1161/CIR.0000000000000509 [DOI]
6. Krzesiński P. Digital health technologies for post-discharge care after heart failure hospitalisation to relieve symptoms and improve clinical outcomes. Journal of Clinical Medicine. 2023;12(6):2373. doi: 10.3390/jcm12062373 [DOI] [PMID] [PMCID]
7. Bozkurt B, Khalaf S. Heart failure in women. Methodist DeBakey Cardiovascular Journal. 2017;13:216-23. doi: 10.14797/mdcj-13-4-216 [DOI] [PMID] [PMCID]
8. Maric-Bilkan C. Sex differences in micro- and macro-vascular complications of diabetes mellitus. Clinical Science. 2017;131:833-46.
https://doi.org/10.1042/CS20160998 [DOI] [PMID]
9. Leening MJG, Ferket BS, Steyerberg EW, Safdar B, Diercks D. Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population-based cohort study. Bmj. 2014;349:g5992.
https://doi.org/10.1136/bmj.g5992 [DOI] [PMID] [PMCID]
10. Cediel G, Codina P, Spitaleri G, Domingo M, Santiago-Vacas E, Lupón J, et al. Gender-related differences in heart failure biomarkers. Frontiers in Cardiovascular Medicine. 2021;7:617705. doi: 10.3389/fcvm.2020.617705. [DOI] [PMID] [PMCID]
11. Shin J. J , Hamad E , Murthy S, Piña I.L. Heart Failure in Women. Clinical Cardiology. 2012; 35(3):172-177. doi.org/10.1002/clc.21973 [DOI] [PMID] [PMCID]
12. Conde-Martel A, Arkuch ME, Formiga F, Manzano-Espinosa L, Aramburu-Bodas O, González-Franco Á, et al. Gender related differences in clinical profile and outcome of patients with heart failure. Results of the RICA Registry. Revista Clínica Española. 2015;215(7):363-70. English, Spanish. doi: 10.1016/j.rce.2015.02.010. [DOI] [PMID]
13. Strömberg A, Mårtensson J. Gender differences in patients with heart failure. European Journal of Cardiovascular Nursing. 2003;2(1):7-18. doi: 10.1016/S1474-5151(03)00002-1. [DOI] [PMID]
14. Mårtensson J, Dracup K, Canary C, Fridlund B. Living with heart failure: depression and quality of life in patients and spouses. The Journal of heart and lung transplantation. 2003;22(4):460-7. doi: 10.1016/s1053-2498(02)00818-5. [DOI] [PMID]
15. Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002. doi: 10.1161/01.CIR.0000039105.49749.6F. [DOI] [PMID]
16. Patrizio M, Marano G. Gender differences in cardiac hypertrophic remodeling. Annali dell'Istituto Superiore di Sanità. 2016;52(2):223-229. doi: 10.4415/ANN_16_02_14. [Google Scholar]
17. Mejhert M, Kahan T, Edner M, Persson HE. Sex differences in systolic heart failure in the elderly: the prognostic importance of left ventricular mass in women. Journal of Women's Health. 2008;17(3):373-81. doi: 10.1089/jwh.2007.0487. [DOI] [PMID]
18. Stoberock K, Debus ES, Gülsen A, Günther D, Larena-Avellaneda A, Eifert S, et al. Gender differences in patients with carotid stenosis. Vasa Zeitschrift Für Gefässkrankheiten 2016; 45:11. doi: 10.1024/0301-1526/a000490. [DOI] [PMID]
19. Hussein H A, Sameeha A, Hussam H A, Aseel A, Dina A A, Leen A. Blood Pressure and Its Association with Gender, Body Mass Index, Smoking, and Family History among University Students. International Journal of Hypertension. 2018;2018:1-5. [DOI:1] [PMID] [PMCID]
20. Cesaroni G, Mureddu GF, Agabiti N, Mayer F, Stafoggia M, Forastiere F, et al. Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study. BMC Public Health. 2021;21(1):415. doi: 10.1186/s12889-021-10442-3. [DOI] [PMID] [PMCID]
21. Crislip GR, Sullivan JC. T-cell involvement in sex differences in blood pressure control. Clinical Science. 2016;130:773-83.
https://doi.org/10.1042/CS20150620 [DOI] [PMID] [PMCID]
22. Lam CS, Arnott C, Beale AL, Chandramouli C, Hilfiker-Kleiner D, Kaye DM, et al. Sex differences in heart failure. European heart journal. 2019;40(47):3859-68c. doi: 10.1093/eurheartj/ehz835. [DOI] [PMID]
23. Eugene AR. Gender based dosing of metoprolol in the elderly using population pharmacokinetic modeling and simulations. International Journal of Clinical Pharmacology & Toxicology. 2016;5:209-215. [DOI]
24. Freeman J V, Reynolds K, Fang M, Udaltsova N, Steimle A, Pomernacki N K. Digoxin and Risk of Death in Adults With Atrial Fibrillation. Circulation: Arrhythmia and Electrophysiology. 2015;8:49-58. doi: 10.1161/CIRCEP.114.002292. [DOI] [PMID] [PMCID]
25. Parikh RR, Patel KR, Pergolizzi JV Jr, Breve F, Magnusson P. Effects of Digoxin in Heart Failure (HF) With Reduced Ejection Fraction (EF). Cureus. 2022;14(3):e22778. doi:10.7759/cureus.22778. [DOI]
26. Adamson RM, Stahovich M, Chillcott S, et al. Clinical strategies and outcomes in advanced heart failure patients older than 70 years of age receiving the HeartMate II left ventricular assist device: a community hospital experience. Journal of the American College of Cardiology. 2011;57:2487-2495. doi: 10.1016/j.jacc.2011.01.043. [DO] [PMID]
27. Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and patients on guideline-recommended treatment of chronic heart failure in a cross-sectional study. European Journal of Heart Failure. 2009; 11: 299-303. doi: 10.1093/eurjhf/hfn041. [DOI] [PMID] [PMCID]
28. Pop D, Penciu OM, Sitar-Taut AV, Zdrenghea DT. Comparative heart failure profile over a 3-year period in a Romanian general hospital. Clinical Interventions in Aging. 2013;8:999-1005. doi: 10.2147/CIA.S46760. [DOI] [PMID] [PMCID]
29. Ko SH, Jung Y. Energy Metabolism Changes and Dysregulated Lipid Metabolism in Postmenopausal Women. Nutrients. 2021;13(12):4556. doi: 10.3390/nu13124556. [DOI] [PMID] [PMCID]
30. Hajar R. Risk Factors for Coronary Artery Disease: Historical Perspectives. Heart Views. 2017;18(3):109-114. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_106_17. [DOI] [PMID] [PMCID]
31. Avesta L, Rasoolzadeh S, Naeim M, Kamran A. Prevalence of Cardiovascular Disease Risk Factors in the Women Population Covered by Health Centers in Ardabil. International Journal of Hypertension. 2022;2022:2843249. doi: 10.1155/2022/2843249. [DOI] [PMID] [PMCID]
32. Adams KF, Dunlap SH, Sueta CA, Clarke SW, Patterson JH, Blauwet MB, et al. Relation between gender, etiology and survival in patients with symptomatic heart failure. Journal of the American College of Cardiology. 1996;28(7):1781-8. doi: 10.1016/S0735-1097(96)00380-4. [DOI] [PMID]
33. Schnabel RB, Yin X, Gona P, Larson MG, Beiser AS, McManus DD, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015;386:154-162. doi:10.1016/S0140-6736(14)61774-8. [DOI] [PMID]
34. Wannamethee SG, Papacosta O, Lennon L, Hingorani A, Whincup P. Adult height and incidence of atrial fibrillation and heart failure in older men: The British Regional Heart Study. International Journal of Cardiology. Heart & Vasculature. 2021;35:100835. doi: 10.1016/j.ijcha.2021.100835. [DOI] [PMID] [PMCID]
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