Christina Magnussen1, Teemu J Niiranen2, Francisco M Ojeda3, Francesco Gianfagna4, Stefan Blankenberg1, Erkki Vartiainen5, Susana Sans6, Gerard Pasterkamp7, Maria Hughes8, Simona Costanzo9, Maria Benedetta Donati9, Pekka Jousilahti5, Allan Linneberg10, Tarja Palosaari5, Giovanni de Gaetano9, Martin Bobak11, Hester M den Ruijter12, Torben Jørgensen13, Stefan Söderberg14, Kari Kuulasmaa5, Tanja Zeller1, Licia Iacoviello4, Veikko Salomaa5, Renate B Schnabel15. 1. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research, partner site Hamburg/Kiel/Luebeck, Germany. 2. Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland; National Institute for Health and Welfare, Helsinki, Finland. 3. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. 4. Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy; Centre for Research in EPIdemiology and preventive MEDicine (EPIMED) Department of Medicine and Surgery, University of Insubria, Varese, Italy. 5. National Institute for Health and Welfare, Helsinki, Finland. 6. Catalan Department of Health, Barcelona, Spain. 7. Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, the Netherlands. 8. Center of Excellence for Public Health, Institute of Clinical Sciences, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, Northern Ireland. 9. Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy. 10. Centre for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark; Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. 11. Department of Epidemiology and Public Health, University College London, London, United Kingdom. 12. Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands. 13. Centre for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Faculty of Medicine, University of Aalborg, Aalborg, Denmark. 14. Department of Public Health and Clinical Medicine, and Heart Centre, Umeå University, Umeå, Sweden. 15. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research, partner site Hamburg/Kiel/Luebeck, Germany. Electronic address: r.schnabel@uke.de.
Abstract
OBJECTIVES: This study investigates differences between women and men in heart failure (HF) risk and mortality. BACKGROUND: Sex differences in HF epidemiology are insufficiently understood. METHODS: In 78,657 individuals (median 49.5 years of age; age range 24.1 to 98.7 years; 51.7% women) from community-based European studies (FINRISK, DanMONICA, Moli-sani, Northern Sweden) of the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium, the association between incident HF and mortality, the relationship of cardiovascular risk factors, prevalent cardiovascular diseases, biomarkers (C-reactive protein [CRP]; N-terminal pro-B-type natriuretic peptide [NT-proBNP]) with incident HF, and their attributable risks were tested in women vs. men. RESULTS: Over a median follow-up of 12.7 years, fewer HF cases were observed in women (n = 2,399 [5.9%]) than in men (n = 2,771 [7.3%]). HF incidence increased markedly after 60 years of age, initially with a more rapid increase in men, whereas incidence in women exceeded that of men after 85 years of age. HF onset substantially increased mortality risk in both sexes. Multivariable-adjusted Cox models showed the following sex differences for the association with incident HF: systolic blood pressure hazard ratio (HR) according to SD in women of 1.09 (95% confidence interval [CI]: 1.05 to 1.14) versus HR of 1.19 (95% CI: 1.14 to 1.24) in men; heart rate HR of 0.98 (95% CI: 0.93 to 1.03) in women versus HR of 1.09 (95% CI: 1.04 to 1.13) in men; CRP HR of 1.10 (95% CI: 1.00 to 1.20) in women versus HR of 1.32 (95% CI: 1.24 to 1.41) in men; and NT-proBNP HR of 1.54 (95% CI: 1.37 to 1.74) in women versus HR of 1.89 (95% CI: 1.75 to 2.05) in men. Population-attributable risk of all risk factors combined was 59.0% in women and 62.9% in men. CONCLUSIONS: Women had a lower risk for HF than men. Sex differences were seen for systolic blood pressure, heart rate, CRP, and NT-proBNP, with a lower HF risk in women.
OBJECTIVES: This study investigates differences between women and men in heart failure (HF) risk and mortality. BACKGROUND: Sex differences in HF epidemiology are insufficiently understood. METHODS: In 78,657 individuals (median 49.5 years of age; age range 24.1 to 98.7 years; 51.7% women) from community-based European studies (FINRISK, DanMONICA, Moli-sani, Northern Sweden) of the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium, the association between incident HF and mortality, the relationship of cardiovascular risk factors, prevalent cardiovascular diseases, biomarkers (C-reactive protein [CRP]; N-terminal pro-B-type natriuretic peptide [NT-proBNP]) with incident HF, and their attributable risks were tested in women vs. men. RESULTS: Over a median follow-up of 12.7 years, fewer HF cases were observed in women (n = 2,399 [5.9%]) than in men (n = 2,771 [7.3%]). HF incidence increased markedly after 60 years of age, initially with a more rapid increase in men, whereas incidence in women exceeded that of men after 85 years of age. HF onset substantially increased mortality risk in both sexes. Multivariable-adjusted Cox models showed the following sex differences for the association with incident HF: systolic blood pressure hazard ratio (HR) according to SD in women of 1.09 (95% confidence interval [CI]: 1.05 to 1.14) versus HR of 1.19 (95% CI: 1.14 to 1.24) in men; heart rate HR of 0.98 (95% CI: 0.93 to 1.03) in women versus HR of 1.09 (95% CI: 1.04 to 1.13) in men; CRP HR of 1.10 (95% CI: 1.00 to 1.20) in women versus HR of 1.32 (95% CI: 1.24 to 1.41) in men; and NT-proBNP HR of 1.54 (95% CI: 1.37 to 1.74) in women versus HR of 1.89 (95% CI: 1.75 to 2.05) in men. Population-attributable risk of all risk factors combined was 59.0% in women and 62.9% in men. CONCLUSIONS:Women had a lower risk for HF than men. Sex differences were seen for systolic blood pressure, heart rate, CRP, and NT-proBNP, with a lower HF risk in women.
Authors: Alanna M Chamberlain; Cynthia M Boyd; Sheila M Manemann; Shannon M Dunlay; Yariv Gerber; Jill M Killian; Susan A Weston; Véronique L Roger Journal: Am J Med Date: 2019-11-17 Impact factor: 4.965
Authors: Emily S Lau; Aleksandra Binek; Sarah J Parker; Svati H Shah; Markella V Zanni; Jennifer E Van Eyk; Jennifer E Ho Journal: Circ Res Date: 2022-02-17 Impact factor: 23.213
Authors: Navin Suthahar; Emily S Lau; Michael J Blaha; Samantha M Paniagua; Martin G Larson; Bruce M Psaty; Emelia J Benjamin; Matthew A Allison; Traci M Bartz; James L Januzzi; Daniel Levy; Laura M G Meems; Stephan J L Bakker; Joao A C Lima; Mary Cushman; Douglas S Lee; Thomas J Wang; Christopher R deFilippi; David M Herrington; Matthew Nayor; Ramachandran S Vasan; Julius M Gardin; Jorge R Kizer; Alain G Bertoni; Norrina B Allen; Ron T Gansevoort; Sanjiv J Shah; John S Gottdiener; Jennifer E Ho; Rudolf A de Boer Journal: J Am Coll Cardiol Date: 2020-09-22 Impact factor: 24.094
Authors: Bente Morseth; Bastiaan Geelhoed; Allan Linneberg; Lars Johansson; Kari Kuulasmaa; Veikko Salomaa; Licia Iacoviello; Simona Costanzo; Stefan Söderberg; Teemu J Niiranen; Julie K K Vishram-Nielsen; Inger Njølstad; Tom Wilsgaard; Ellisiv B Mathiesen; Maja-Lisa Løchen; Tanja Zeller; Stefan Blankenberg; Francisco M Ojeda; Renate B Schnabel Journal: Open Heart Date: 2021-07