Hartfalen bij mannen en vrouwen: belangrijke verschillen in diagnostiek en behandeling

Objective

To determine gender differences in diagnostic workup and treatment of patients with heart failure.

Design

Retrospective.

Method

The data of 8914 patients (of whom 4166 women; 47) with confirmed heart failure, who participated in the Euro Heart Survey on Heart Failure (EHS-HF) were analysed.

Results

On average, the women in the study were older than the men (75 versus 68 years) and less often suffered from a coronary heart disease (56 versus 66). Women were more likely to have hypertension (59 versus 49), diabetes mellitus (29 versus 26), or valvular heart disease (42 versus 36). Fewer women had an ultrasonographic evaluation of ventricular function (59 versus 74) and, among those investigated, fewer had left ventricular systolic dysfunction (44 versus 71). These observed results remained stable after adjustment for age and other possible confounding variables. Medication with a documented positive impact on survival, i.e. angiotensin converting enzyme (ACE) inhibitors, β-blocking drugs and the diuretic spironolactone, was prescribed less often to women than men. Women, however, received symptomatic medication such as other diuretics and digoxin more often than men.

Conclusion

Men and women with heart failure differed with respect to a number of relevant clinical characteristics. Clinicians should take good note of this and take measures to prevent differences in patient care.

Ned Tijdschr Geneeskd. 2008;152:2182-5