Women also more likely to hospitalised for heart failure

More women than men are dying from heart failure and they are also more likely to require hospital care, a new study has found.

According to the study from researchers in Canada, death rates from heart failure are higher for women than men, and hospitalisation rates have increased in women while declining 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,” said Dr Louise Sun, University of Ottawa Heart Institute, Ottawa, Ontario.

Heart failure is a major cause of illness and death and accounts for 35 per cent of total female cardiovascular deaths. Recent research indicates heart failure rates have declined, although information on sex differences in outcomes for men and women is lacking.

Therefore, to understand sex differences in heart failure outcomes, researchers looked at data on more than 90,000 patients diagnosed with heart failure in Ontario over 5 years (2009 to 2014).

Of the total cases, 47 per cent were female and were more likely to be older and frailer, to have lower income and to have multiple chronic illnesses.

The number of new heart failure cases was lowest in 2011 and 2012, they then began to rise the following year. Within one year of follow-up after diagnosis, 16.8% (7,156) women died compared with 14.9% (7,138) men. During 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. Further studies should focus on sex differences in health-seeking behaviour, medical therapy and response to therapy to improve outcomes in women,” the authors wrote.

Commenting on the study Dr Angie Brown, Consultant Cardiologist and Medical Director of the Irish Heart Foundation said, “This study shows that heart failure remains a leading cause of cardiovascular morbidity and mortality accounting for 35 per cent of cardiovascular deaths. It’s a common condition with a prevalence of 1-2 per cent and though treatments are improving all the time this study highlights how the improvement in mortality and hospital admissions isn’t being seen in women. Further work is needed to fully understand these differences but females in this study were older and there was more hypertensive heart disease. As we are living longer these issues are even more important to address. By increasing awareness of the causes of heart failure we can improve treatment of risk factors for heart failure such as high blood pressure and so reduce prevalence as well as making an earlier diagnosis and making lifestyle and treatment interventions early.”

This study was published on July 16 in the Canadian Medical Association Journal (CMAJ).