Women Fare Better With Heart Failure
European analysis of study data found a higher risk of death in male heart failure patients
Thursday, March 8, 2012
An analysis of data from 31 studies involving more than 40,000 heart failure patients found that 25.3 percent of female patients and 25.7 percent of male patients died over three years of follow-up. The death rate was 135 deaths per 1,000 patient years in women and 137 per 1,000 patient years in men.
However, when the researchers adjusted for age, they found that male patients had a 31 percent higher risk of death than female patients, and that being male was an independent risk factor for death.
Compared to men, women with heart failure tend to be older, are more likely to have a history of hypertension and diabetes, and are less likely to have heart failure that is caused by reduced blood supply to the heart, the researchers said.
The study also found that heart failure patients whose left ventricular ejection fraction is not reduced have a lower death risk than those with reduced ejection fraction. Reduced ejection fraction is more common in male heart failure patients than in female patients.
Left ventricular ejection fraction is a measurement used to assess the function of the left ventricle, which pumps blood into the body's circulatory system.
Overall, female heart failure patients were prescribed fewer recommended treatments for heart failure than men -- including angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) and beta blockers.
The findings were published March 8 in the European Society of Cardiology's European Journal of Heart Failure.
"This study has clearly demonstrated that survival is better for women with heart failure than for men, irrespective of ejection fraction, age or other variables," first author Dr. Manuel Martinez-Selles from the Gregorio Maranon University Hospital in Madrid, Spain, said in a journal news release.
There are several possible explanations why women may fare better than men, he added, including that "the female heart appears to respond to injury differently from the male heart."
Women show less "ventricular remodeling," or structural changes to the size, shape and function of the heart; greater preservation of right ventricular function; and seem to be more protected from ventricular arrhythmias and cell death.
"Some of these advantages could be related to pregnancy and to sex-specific differences in gene expression," Martinez-Selles said.
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