Management of Heart Failure (HF): Is there a difference in genders? Results from the NATURE-HF Registry

Abstract

Around 25 million people around the world are suffering from heart failure (HF), and each year 2 million new cases of HF are diagnosed. Despite the therapeutic improvement in the treatment of HF, its incidence and prevalence is still increasing. Evidence from the literature showed that gender discrepancies in HF management may exist. The aim of our study was to compare the management of HF between the genders. NATURE HF is a prospective registry including 2040 patients diagnosed with HF from October 2017 to January 2019. Management of HF was compared between genders at one-year follow-up. 2040 patients were included: 70.9% male patients and 29.1% female patients. Women were older than men (mean age 65.69 ± 12 vs. 62.6 ± 12; P < 0.001). Diabetes and hypertension were significantly higher in female patients with HF (40.9 vs., 33.8% P = 0.002) and (51.9 vs. 35.7%, P < 0.001), respectively. Smoking was significantly higher in male patients (34.9 vs. 5.2%, P < 0.001). Ischemic cardiomyopathy was significantly higher in male patients (52 vs. 32.3%, P < 0.001) whereas valvular and dilated cardiomyopathy were higher in women (14.3% vs. 8.1%, P < 0.001; 18.2 vs.14.4%; P = 0.032), respectively. Mean left ventricular ejection fraction was significantly higher in female patients (40.94 ± 10.9% vs. 37.4 ± 10.1%, P < 0.001). Beta-blockers, Digoxin and Furosemide were significantly less prescribed to female patients (60.8 vs. 66.9%, P = 0.008; 9.4 vs. 3%, P < 0.001; 62.5 vs.52%; P < 0.001 respectively), while ARA 2 were prescribed significantly less to male patients (4.5 vs. 7.1%, P = 0.018). There was no significant difference between gender in ACE inhibitors and Ivabradin prescription (59.8 vs. 63.8%; P = 0.104 vs. 0.6%, P = 0.752 respectively). Gender differences were detected in clinical presentation and management of HF. Female patients with HF were undertreated by Beta-blockers, Digoxin and Furosemid.