Abstract 10912: Sex Differences in Clinical Characteristics and Outcomes in Elderly Patients with Heart Failure and Preserved Ejection Fraction: The I-PRESERVE Trial
Background: In contrast to the wealth of data describing sex differences in heart failure with reduced ejection fraction (HFREF), there are few sex-specific data in heart failure with preserved ejection fraction (HFPEF). We hypothesized that there would be sex differences in baseline characteristics that could predispose to differences in outcomes in HFPEF.
Methods: We examined the association of sex with clinical characteristics and outcomes in 4128 patients in the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial.
Results: Women (N=2491) with HFPEF were older (72±7 vs 71±7 y), more obese (46 vs 35%) and more likely to have chronic kidney disease (CKD) (34 vs 26%), history of hypertension (91 vs 85%) and worse HF-specific quality of life than men; but less likely to have an ischemic etiology (19 vs 34%), atrial fibrillation (27 vs 33%) or chronic obstructive pulmonary disease (COPD) (8 vs 13%)(all p<0.001). Over a mean of 49.5 months, women had significantly lower risk of all-cause, cardiovascular (CV) and non-CV events than men, and were not significantly different for HF-specific events (Table). In both men and women, independent predictors of all-cause hospitalizations and deaths were age, COPD, lower hemoglobin and higher natriuretic peptides. Additional independent predictors in women alone were obesity, diabetes, and CKD, and in men alone were smoking and neutrophil count.
Conclusions: In typical patients with HFPEF, there were prominent sex differences in baseline characteristics. Despite worse quality of life, women had better overall prognosis than men, mainly due to decreased risk of non-HF-related outcomes. There was significant sex divergence in the independent predictors of all-cause hospitalizations and deaths, with obesity, diabetes and CKD being most prominent in women. This information may be helpful in future efforts at prevention and treatment of this important disorder.
- © 2011 by American Heart Association, Inc.