In older patients with HFpEF, worse outcomes for women than men
Female sex was independently associated with diastolic dysfunction and worse clinical outcomes in a cohort of older patients with HF with preserved ejection fraction, researchers reported.
The researchers conducted the PURSUIT-HFpEF prospective, multicenter, observational study of 871 patients (55% women) with HFpEF.
The clinical endpoint was a composite of all-cause death and HF readmission. The echocardiographic endpoint was diastolic dysfunction. Mean follow-up was 399 days.
Compared with men, women were older (82 vs. 80 years); were less likely to have hypertension, CAD and chronic kidney disease; were less likely to be smokers; and had lower C-reactive protein levels, the researchers wrote.
Angiotensin II receptor blockers, calcium channel blockers and antiplatelet drugs were more frequently used in men than in women, the researchers wrote.
Diastolic dysfunction was more common in women than in men (52.8% vs. 32%; P < .001), Yohei Sotomi, MD, PhD, from the department of cardiovascular medicine at Osaka University Graduate School of Medicine, Japan, and colleagues wrote.
In an unadjusted analysis, there was no difference by sex in incidence of the clinical endpoint (women, 36.1 per 100 person-years; men, 30.5 per 100 person-years; P = .336), but after adjustments, female sex was an independent predictor of the echocardiographic endpoint (adjusted OR = 2.839; 95% CI, 1.884-4.278; P < .001) and the clinical endpoint (aHR = 1.538; 95% CI, 1.143-2.07; P = .004).
“Sex differences in HFpEF suggest the need for further research to better understand underlying pathophysiology, including contributions of sex hormones and sex hormone deficiency, and thereby identify novel preventive and disease-modifying treatments for HFpEF,” the researchers wrote.