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J Thorac Cardiovasc Surg 2004;127:1247-1252
© 2004 The American Association for Thoracic Surgery

Editorial

Is it important to examine gender differences in the epidemiology and outcome of severe heart failure?

Mariell Jessup, MDa,*, Ileana L. Piña, MDb

a University of Pennsylvania, Philadelphia, Pa, USA
b Case Western Reserve University, Cleveland, Ohio, USA

Received for publication July 29, 2003; accepted for publication September 9, 2003.

* Address for reprints: Mariell Jessup, MD, Heart Failure/Transplant Program, Hospital of the University of Pennsylvania, 6 Penn Tower, 3400 Spruce St, Philadelphia, PA 19104, USA
jessupm@uphs.upenn.edu

The first 300 words of the full text of this article appear below.


See related editorials on pages 1245 and 1253.

 

Nearly 5 million Americans have heart failure (HF) today, with an incidence approaching 10 per 1000 population in persons older than 65 years of age; approximately 50% of these patients are women (Figure 1).1 In 2000, 62.3% of all HF mortalities occurred among women; 20% of those patients died within 1 year of their diagnosis, and less than 15% of women survive more than 8 to 12 years after diagnosis.2 These results notwithstanding, the Framingham study recently noted that the age-adjusted rates of HF are higher among men, with no significant change in this rate over a 50-year period.3 Among women, the incidence of HF has decreased by 31% to 40% in the decades after 1950.


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  		Figure 1. Prevalence and mortality of heart failure by gender: A, prevalence of heart failure in the United States, 1988 through 1994, by age group and gender; B, mortality (51,546 total deaths, including Hispanics) in 2000. Percentage of male deaths was 37.6%, and percentage of female deaths was 62.4%.1

 
HF is the reason for at least 20% of all hospital admissions in persons older than 65 years, and over the past decade, hospitalizations for HF have increased by 159%. Women who have been hospitalized with HF have less improvement in physical health status and perceive their quality of care to be lower than that of their male cohorts.4 Of the thousands of patients disabled from HF within 6 years of their diagnosis, 46% are adult women compared with only 22% of men. In 1997, an estimated $5501 was spent for every hospital-discharge diagnosis of HF, and another $1742 per month was required to care for each patient after discharge. Gender has been shown to be an important determinant of hospital length of stay, hospital charges, . . . [Full Text of this Article]


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