Influence of gender on heart failure among hospitalised Nigerian patients.

BACKGROUND: Heart failure is a global phenomenon with poor morbi-mortality statistics. Though data abound in the developed nations, they are just becoming available here. There is a perceived neglect of heart failure epidemiology as it affects women; which is getting some attention in the advanced nations. This work attempts to see how gender impacts on heart failure in our environment and to provide insight on how any peculiarities could be approached.

METHOD: As part of a larger study on relationship between 6 minute walk test and left ventricular systolic function in heart failure patients in our centre (July 2012 to June 2013), we dichotomized the cases along the line of gender. This was to see what differences may be related to the genders. All patients had history, physical examination and investigations including echocardiography which formed the bases for comparison.

RESULTS: There were 140 patients, 85 (60.7%) of whom were females. Mean age was 48.2 (14.5) years; but males were significantly older [53.8 (12.6) Vs 44.6 (14.6)]. Heart failure under 45 years affected women more. More males drank and smoked. While diabetes was more common in males, more females had hypertension and rheumatic heart disease as aetiologies. Females tended to be more symptomatic but the difference did not attain statistical significance. Renal function tended to be worse in males.

CONCLUSION: Women tend to go into heart failure earlier than men in our environment and had more hypertension and rheumatic heart disease as causes. Renal function was worse in males given a greater constellation of cardiovascular disease risk factors namely alcohol use, smoking and diabetes. More effort should go into preventing rheumatic heart disease and hypertension which result in heart failure in women. Obstetric encounters for cerebrovascular disease evaluation should be taken more seriously since these conditions are likely to result in failure related to pregnancy and child-birth.