Psychosocial factors may explain quality of life gap in patients with HF
The gap in quality of life between men and women with HF may be explained by the interaction between biological and psychosocial factors, according to a study published in ESC Heart Failure.
In an observational, prospective analysis of 1,236 patients diagnosed with chronic HF between 2004 and 2014, the researchers analyzed data from the Minnesota Living with Heart Failure Questionnaire to determine quality of life (QoL) of patients along three dimensions: physical, emotional and social.
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“We have found that female gender is an independent predictor of poorer overall, physical and emotional QoL in models adjusted only for biological factors,” Javier Tapia, MD, of the department of clinical sciences at the University of Barcelona School of Medicine, and colleagues wrote. “The trend is reversed in the social dimension: female gender predicts better social QoL compared with male gender. Interestingly, this influence is canceled out in comprehensive models that include both biological and psychosocial factors.”
The researchers found that female gender was an independent predictor of worse global (HR = 1.6; 95% CI, 1.1-2.3; P = .005), physical (HR = 1.5; 95% CI, 1-2.1; P = .018) and emotional (HR = 2.1; 95% CI, 1.5-2.9; P < .001) QoL scores compared with male gender. However, female gender was an independent predictor of better social (HR = 0.6, 95% CI, 0.4-0.9; P = .039) QoL scores compared with male gender.
Comprehensive multivariable linear regression models that included gender, age and all determinants took into account both clinical and psychosocial determinants. These models showed that female gender was no longer an independent predictor of lower QoL compared with male gender.
“Clinical factors are the main drivers of QoL. However, the contribution of psychosocial factors is essential to definitively understand the role of gender in patient-reported outcomes,” Tapia and colleagues wrote.
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