Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

BMC Public Health

Gian Francesco Mureddu¹  Marina Davoli²  Giulia Cesaroni²  Nera Agabiti²  Massimo Stafoggia²  Francesco Forastiere²  Roberto Latini³  Serge Masson³  Flavia Mayer⁴  Alessandro Boccanelli⁵ 

[1] Cardiology and Cardiovascular Rehabilitation Unit, S. Giovanni-Addolorata Hospital, Rome, Italy;Department of Epidemiology - Regional Health Service, ASL Roma 1, Via C. Colombo 112, 00147, Rome, Italy;Mario Negri Institute for Pharmacological Research – IRCCS, Milan, Italy;National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy;Quisisana Clinic, Rome, Italy;

关键词: Heart failure;    Diastolic left ventricular dysfunction;    Sex differences;    Risk factors;    Elderly;    NT-proBNP;   

DOI  :  10.1186/s12889-021-10442-3

来源: Springer

【 摘 要 】

BackgroundAlthough sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study.MethodsA random sample of 2001 65–84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP.ResultsIn 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women.ConclusionsThere were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors.

【 授权许可】

CC BY