Substantial progress in the management of heart failure has been made over the past decade. Still, mortality rates from heart failure remain higher for women than men, according to a new study published in CMAJ (Canadian Medical Association Journal). The study, which covered a five-year period ((2009 to 2014), also found that rates of hospital admission for heart failure increased in women and declined in men.
"This is the first of a series of studies to examine the sex differences in heart failure incidence, outcomes, care delivery and access in Ontario," says lead author Dr. Louise Sun, University of Ottawa Heart Institute, Ottawa, Ontario.
Heart failure is a major cause of illness and death and accounts for 35 percent of total female cardiovascular deaths. Recent research indicates heart failure rates have declined, but there is limited data on sex differences in outcomes for men and women.
To understand sex differences in heart failure outcomes, Dr. Sun and colleagues reviewed data on more than 90 000 patients diagnosed with heart failure in Ontario between 1 April 2009 and 31 March 2014. Of the total cases, 47 percent were female and were more likely to be older and frailer, to have lower income and to have multiple chronic illnesses.
Data analysis revealed that the number of new heart failure cases was lowest in 2011 and 2012, then began to rise the following year. Within one year of follow-up after diagnosis, 16.8 percent (7,156) women died compared with 14.9 percent (7,138) men. During the five-year the study period, hospitalisation rates for women surpassed rates for men, with 98 women per 1,000 hospitalised in 2013 compared with 91 per 1,000 men.
"We found that mortality from heart failure remains high, especially in women; that hospital admissions for heart failure decreased in men but increased in women; and that women and men had different associated comorbidities," write the authors.
The authors note that future studies should focus on sex differences in health-seeking behaviour, medical therapy and response to therapy to improve outcomes in women.
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