Giulia Cesaroni1, Gian Francesco Mureddu2, Nera Agabiti3, Flavia Mayer4, Massimo Stafoggia3, Francesco Forastiere3, Roberto Latini5, Serge Masson5, Marina Davoli3, Alessandro Boccanelli6. 1. Department of Epidemiology - Regional Health Service, ASL Roma 1, Via C. Colombo 112, 00147, Rome, Italy. g.cesaroni@deplazio.it. 2. Cardiology and Cardiovascular Rehabilitation Unit, S. Giovanni-Addolorata Hospital, Rome, Italy. 3. Department of Epidemiology - Regional Health Service, ASL Roma 1, Via C. Colombo 112, 00147, Rome, Italy. 4. National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy. 5. Mario Negri Institute for Pharmacological Research - IRCCS, Milan, Italy. 6. Quisisana Clinic, Rome, Italy.
Abstract
BACKGROUND: Although sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study. METHODS: A random sample of 2001 65-84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP. RESULTS: In 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women. CONCLUSIONS: There were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors.
BACKGROUND: Although sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study. METHODS: A random sample of 2001 65-84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP. RESULTS: In 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women. CONCLUSIONS: There were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors.
Entities:
Keywords:
Diastolic left ventricular dysfunction; Elderly; Heart failure; NT-proBNP; Risk factors; Sex differences
Authors: S Masson; R Latini; G F Mureddu; N Agabiti; M Miceli; G Cesaroni; F Forastiere; U-H Wienhues-Thelen; D Block; C Zaugg; T Vago; A Boccanelli Journal: J Intern Med Date: 2012-12-28 Impact factor: 8.989
Authors: Ruby C Lo; Rodney P Bensley; Suzanne E Dahlberg; Robina Matyal; Allen D Hamdan; Mark Wyers; Elliot L Chaikof; Marc L Schermerhorn Journal: J Vasc Surg Date: 2013-09-29 Impact factor: 4.268
Authors: Maarten J G Leening; Bart S Ferket; Ewout W Steyerberg; Maryam Kavousi; Jaap W Deckers; Daan Nieboer; Jan Heeringa; Marileen L P Portegies; Albert Hofman; M Arfan Ikram; M G Myriam Hunink; Oscar H Franco; Bruno H Stricker; Jacqueline C M Witteman; Jolien W Roos-Hesselink Journal: BMJ Date: 2014-11-17