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Sex differences in new-onset heart failure

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Abstract

Background

Sex differences in patients with established heart failure have been well described, but much less is known in the development of heart failure.

Methods

We studied sex-specific incidence and risk of new-onset heart failure in 8592 subjects (mean age 49.2 ± 12.7 years; 50.1 % women) of the Prevention of REnal and Vascular ENdstage Disease (PREVEND) study and distinguished reduced and preserved ejection fraction (HFrEF <40 % and HFpEF >50 %).

Results

Of 374 cases with incident heart failure, 241 (64.4 %) occurred in men and 133 (35.6 %) in women (median follow-up 12.5 years; 96,550 person-years). Men developed heart failure earlier (7.0 vs. 8.6 years; P < 0.001). Incidence rates per 1,000 person-years in women compared to men were lower for HFrEF (1.2 vs. 3.0 %; P < 0.001), but higher for HFpEF (1.2 vs. 0.7 %; P < 0.001). Women developed HFpEF later in life than HFrEF (75.1 vs. 69.7 years; P = 0.033), while men showed no significant difference (72.2 vs. 69.5 years; P = 0.116). Multivariable competing risks analyses showed that women had lower risk for HFrEF (subhazard ratio = 0.47; 95 % CI 0.29–0.76, P = 0.002) but higher risk for HFpEF (subhazard ratio = 2.16; 95 % CI 1.21–3.83, P = 0.009) than men. Among all risk factors, only atrial fibrillation had a sex-specific predictive value and increased risk specifically for women (P-for interaction = 0.016).

Conclusions

In a middle-aged population, men developed heart failure more frequently and at a younger age than women. However, women had higher risk for HFpEF, with atrial fibrillation being a specific female risk factor.

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Acknowledgments

The PREVEND study was financially supported by Grant E0.13 of the Dutch Kidney Foundation.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands

    Sven Meyer, Frank P. Brouwers, Adriaan A. Voors, Rudolf A. de Boer, Pim van der Harst, Michiel Rienstra, Isabelle C. van Gelder, Dirk J. van Veldhuisen, Wiek H. van Gilst & Peter van der Meer

  2. Department of Cardiology, Heart Center Oldenburg, Oldenburg, Germany

    Sven Meyer

  3. Trial Coordination Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Hans L. Hillege

  4. Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Ron T. Gansevoort

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  1. Sven Meyer
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  2. Frank P. Brouwers
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  3. Adriaan A. Voors
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Correspondence to Sven Meyer.

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Meyer, S., Brouwers, F.P., Voors, A.A. et al. Sex differences in new-onset heart failure. Clin Res Cardiol 104, 342–350 (2015). https://doi.org/10.1007/s00392-014-0788-x

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  • DOI: https://doi.org/10.1007/s00392-014-0788-x

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