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Increased rates of HF mortality, hospital admission persist in women
Mortality from HF remains high, especially in women, and the rates of hospital admission for HF increased in women despite decreasing in men from 2009 to 2013, according to a study published in the Canadian Medical Association Journal.
“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,” Louise Y. Sun, MD, staff anesthesiologist at the University of Ottawa Heart Institute and assistant professor in the department of anesthesiology and school of epidemiology, public health and preventive medicine at the University of Ottawa in Ontario, Canada, said in a press release.
Researchers analyzed data from 90,707 patients (47% women) diagnosed with HF in an ambulatory setting between April 2009 and March 2014. Ambulatory settings were defined as HF diagnoses made during an ED visit that did not result in a hospital admission.
The primary outcome was all-cause mortality within 1 year of a HF diagnosis. The secondary outcome of interest was HF hospitalization within 1 year of the diagnosis.
Compared with men with HF, women with HF were more likely to be more frail, to be older and to have comorbid conditions such as pulmonary circulatory disease, hypertension, depression and dementia.
The lowest incidence of HF in men and women occurred in 2011 and 2012, although it started to increase again in 2013.
During the study, both men and women had reductions in age-standardized mortality rates, with women having higher rates compared with men. The age-standardized mortality rate in women was 89 per 1,000 in 2009 (95% CI, 80-100) and 85 per 1,000 in 2013 (95% CI, 75-95). The rate in men was 88 per 1,000 in 2009 (95% CI, 80-97) and 83 per 1,000 in 2013 (95% CI, 75-91).
The age-standardized rate of HF hospital admission was higher in men (103 per 1,000; 95% CI, 93-114) compared with women (90 per 1,000; 95% CI, 79-101) in 2009. Rates were higher in women (98 per 1,000; 95% CI, 86-110) vs. men in 2013 (91 per 1,000; 95% CI, 82-101).
“Despite improvements in medical therapy, mortality from heart failure remains high,” Sun and colleagues wrote. “This is particularly relevant given that ambulatory patients are often perceived to be at lower risk compared with inpatients.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.