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Sex-Related Differences in Heart Failure With Preserved Ejection Fraction.

Publication ,  Journal Article
Dewan, P; Rørth, R; Raparelli, V; Campbell, RT; Shen, L; Jhund, PS; Petrie, MC; Anand, IS; Carson, PE; Desai, AS; Granger, CB; Køber, L ...
Published in: Circ Heart Fail
December 2019

BACKGROUND: To describe characteristics and outcomes in women and men with heart failure with preserved ejection fraction. METHODS: Baseline characteristics (including biomarkers and quality of life) and outcomes (primary outcome: composite of first heart failure hospitalization or cardiovascular death) were compared in 4458 women and 4010 men enrolled in CHARM-Preserved (Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity) (EF≥45%), I-Preserve (Irbesartan in heart failure with Preserved ejection fraction), and TOPCAT-Americas (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial). RESULTS: Women were older and more often obese and hypertensive but less likely to have coronary artery disease or atrial fibrillation. Women had more symptoms and signs of congestion and worse quality of life. Despite this, the risk of the primary outcome was lower in women (hazard ratio, 0.80 [95% CI, 0.73-0.88]), as was the risk of cardiovascular death (hazard ratio, 0.70 [95% CI, 0.62-0.80]), but there was no difference in the rate for first hospitalization for heart failure (hazard ratio, 0.92 [95% CI, 0.82-1.02]). The lower risk of cardiovascular death in women, compared with men, was in part explained by a substantially lower risk of sudden death (hazard ratio, 0.53 [0.43-0.65]; P<0.001). E/A ratio was lower in women (1.1 versus 1.2). CONCLUSIONS: There are significant differences between women and men with heart failure with preserved ejection fraction. Despite worse symptoms, more congestion, and lower quality of life, women had similar rates of hospitalization and better survival than men. Their risk of sudden death was half that of men. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00853658, NCT01035255.

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Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

December 2019

Volume

12

Issue

12

Start / End Page

e006539

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Time Factors
  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Quality of Life
  • Prognosis
  • Middle Aged
 

Citation

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Dewan, P., Rørth, R., Raparelli, V., Campbell, R. T., Shen, L., Jhund, P. S., … McMurray, J. J. V. (2019). Sex-Related Differences in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail, 12(12), e006539. https://doi.org/10.1161/CIRCHEARTFAILURE.119.006539
Dewan, Pooja, Rasmus Rørth, Valeria Raparelli, Ross T. Campbell, Li Shen, Pardeep S. Jhund, Mark C. Petrie, et al. “Sex-Related Differences in Heart Failure With Preserved Ejection Fraction.Circ Heart Fail 12, no. 12 (December 2019): e006539. https://doi.org/10.1161/CIRCHEARTFAILURE.119.006539.
Dewan P, Rørth R, Raparelli V, Campbell RT, Shen L, Jhund PS, et al. Sex-Related Differences in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail. 2019 Dec;12(12):e006539.
Dewan, Pooja, et al. “Sex-Related Differences in Heart Failure With Preserved Ejection Fraction.Circ Heart Fail, vol. 12, no. 12, Dec. 2019, p. e006539. Pubmed, doi:10.1161/CIRCHEARTFAILURE.119.006539.
Dewan P, Rørth R, Raparelli V, Campbell RT, Shen L, Jhund PS, Petrie MC, Anand IS, Carson PE, Desai AS, Granger CB, Køber L, Komajda M, McKelvie RS, O’Meara E, Pfeffer MA, Pitt B, Solomon SD, Swedberg K, Zile MR, McMurray JJV. Sex-Related Differences in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail. 2019 Dec;12(12):e006539.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

December 2019

Volume

12

Issue

12

Start / End Page

e006539

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Time Factors
  • Stroke Volume
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Quality of Life
  • Prognosis
  • Middle Aged