Influence of gender on long-term prognosis of patients with chronic heart failure seen in heart failure clinics

Abstract

Background: Controversy exists concerning the influence of gender in the prognosis of patients with heart failure and no evidence is available fromspecific heart failure clinics. Hypothesis: Women with ambulatory heart failure are managed differently than men, although their prognosis might be better than men. Methods and Results: We analyzed the clinical characteristics, complementary test results, treatment, and prognosis in 4720 patientswith chronic heart failure seen in 62 specializedclinics forming part of amulticenter registry during a mean follow-up of 40 months. The mean age was 65 ± 12 years and 71%weremen. The men were younger than the women andmore often had a history of hyperlipidemia and ischemic heart disease.The men had a more advanced heart failure New York Heart Association (NYHA) functional class (III-IV) than the women and a greater frequency of systolic ventricular dysfunction. The men more often received treatment with β-blockers, vasodilators, and antiplatelet aggregators as well as higher mean doses as compared with the women. The overall survival after the follow-up was similar for both genders, although the women had lower rates of survival free of admission for heart failure. Conclusions: Despite themortality of women andmen with heart failure being similar, the rate of readmission for heart failure is greater in women in specialized heart failure clinics. These results may be associated with the pharmacological treatment differences observed. © 2010 Wiley Periodicals, Inc.