Clinical Investigations Does Heart Failure Therapy Differ According to Patient Sex?
Josep Lupón M.D., Agustín Urrutia, M.D., Beatriz González C.N., Crisanto Díez, M.D., Salvador Altimir, M.D., Carlos Albaladejo, M.D., Teresa Pascual, M.D., Celestino Rey-Joly, M.D., Vicente Valle, M.D.
Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
Objectives. To assess differences in clinical characteristics, treatment and outcome between men and women with heart failure (HF) treated at a multidisciplinary HF unit. All patients had their first unit visit between August 2001 and April 2004.
Patients. We studied 350 patients, 256 men, with a mean age of 65 ± 10.6 years. In order to assess the pharmacological intervention more homogeneously, the analysis was made at one year of follow-up.
Results. Women were significantly older than men (69 ± 8.8 years vs. 63.6 ± 10.9 years, p < 0.001). Significant differences were found in the HF etiology and in co-morbidities. A higher proportion of men were treated with ACEI (83% vs. 68%, p < 0.001) while more women received ARB (18% vs. 8%, p = 0.006), resulting in a similar percentage of patients receiving either of these two drugs (men 91% vs. women 87%). No significant differences were observed in the percentage of patients receiving beta-blockers, loop diuretics, spironolactone, anticoagulants, amiodarone, nitrates or statins. More women received digoxin (39% vs. 22%, p = 0.001) and more men aspirin (41% vs. 31%, p = 0.004). Carvedilol doses were higher in men (29.4 ± 18.6 vs. 23.8 ± 16.4, p = 0.03), ACEI doses were similar between sexes, and furosemide doses were higher in women (66 mg ± 26.2 vs. 56 mg ± 26.2, p < 0.05). Mortality at 1 year after treatment analysis was similar between sexes (10.4% men vs. 10.5% women).
Conclusions. Despite significant differences in age, etiology and co-morbidities, differences in treatment between men and women treated at a multidisciplinary HF unit were small. Mortality at 1 year after treatment analysis was similar for both sexes.
Keywords: heart failure • treatment • sex
Clinical Cardiology Volume 30, Issue 6 , Pages 301 – 305 (June 2007)
Copyright © 2007 Wiley Periodicals, Inc.
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