PS-C24-12: HEALTH-RELATED QUALITY OF LIFE, AND OUTCOMES IN ADULTS WITH HEART FAILURE: AGE AND SEX-RELATED DIFFERENCES AND THE ROLE OF HYPERTENSION

Abstract

Objective: Hypertension is the commonest cause of heart failure. Heart failure is a pandemic and major driver of mortality; limiting disease progression and improving health related quality of life remains the cornerstone of management. There is dearth of information on quality of life in Africans with heart failure. This study examined age and sex related differences and the role of hypertension in the profile, health related quality of life, and clinical outcomes in African adults with heart failure. Design and method: A cross sectional study conducted at the outpatient cardiology clinics of Jos University Teaching Hospital. Two hundred adults with stable heart failure were enrolled using a simple random method. Relevant history, functional class, Charlson comorbidity index were obtained. Physical examination which included electrocardiography, echocardiography, 6 minutes walk distance were done using standard guidelines. Health related quality of life was assessed using the Minnesota living with heart failure questionnaire and graded as good, moderate or poor. Data was analyzed using SPSS version 21. Simple descriptive statistics and multiple logistic regression to determine predictors of moderate and poor quality of life were done. Results: The participants comprised of 104 females and 96 males. More males belonged to higher social class, 21% of the males had health insurance compared to 17% of the females. 48% of the males had atrial fibrillation compared to 33% of the females. About 50% of the participants have heart failure with reduced ejection fraction, there was significant difference in heart failure aetiology below 45 years versus above 45 years in both sexes. The burden of comorbidities was significantly higher in the males and those above 45 years old. There were differences in the individual domain scores of MLHF scores across age groups and sex, the males have a statistically significant poorer quality of life similarly for above 45 year old compared to below 45 year old. The females had higher numbers of hospital admission within the past 12 months and higher hospitalization frequency. functional class 3 or more, 6MWT below 300metres, ejection fraction above 50% and above 6 classes of medication emerged as predictors of moderate/poor MLHF scores in both males and females. Conclusion: This study found significant age and sex-related differences in clinical profile, HRQOL, and clinical outcomes in African adults with HF. Hypertension was the commonest cause of HF. Improved control of hypertension and periodic health related quality of life assessment in patients with HF are advocated to improve outcomes.