Despite decreases in heart failure (HF) incidences and mortality rates in ambulatory patients, mortality remains higher for women, according to a study published July 16 in the Canadian Medical Association Journal. Overall, rates of hospitalization for HF increased in women and decreased in men.
“At a time when heart failure management has greatly improved, detailed sex-stratified outcomes are scarce in hospital-admitted cohorts and unavailable in ambulatory patients,” wrote lead author Louise Sun, MD, of the University of Ottawa Heart Institute in Ontario, Canada. “Given the sex differences in comorbidities and outcomes in heart failure, it is not known whether and how these current changes are modified by sex. An in-depth understanding of these sex differences may help to increase awareness and lead to clinical trials to identify optimal monitoring and treatment strategies in women and men."
More than 90,000 patients in Ontario who were diagnosed with HF in an ambulatory setting over a five-year study period were used as the research cohort, of which 47 percent were women.
At one-year after diagnosis, Sun and colleagues found 16.8 percent of female patients had died compared to 14.9 percent of men.
Female patients exhibiting HF were more likely to be older, more frail, of lower socioeconomic status and exhibit health conditions such as hypertension, pulmonary circulatory disease, COPD and depression.
Post data assessment, the overall mortality rate decreased in both men and women but still remained higher in women. For every 1,000 people, the female mortality rate decreased from 89 in 2009 to 85 in 2013. The male mortality rate dropped from 88 in 2009 to 83 in 2013.
For every 1,000 people, in 2013, 98 women were hospitalized compared to 91 men.
“Despite improvements in medical therapy, mortality from heart failure remains high,” the researchers wrote. “This is particularly relevant given that ambulatory patients are often perceived to be at lower risk compared with inpatients. The age-standardized mortality rates were higher for women than men. However, after multivariable adjustment, female sex was associated with a slightly lower risk of mortality. This observation emphasizes the importance of adjustment for confounding factors in research on heart failure, as well as the evaluation of comorbidities in the management of patients with heart failure.
The researchers noted that further studies should focus on differences in “health seeking behavior,” medical therapy and response to therapy to provide guidance for personalized care.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.