Gender and drug treatment as determinants of mortality in a cohort of heart failure patients.
OBJECTIVE
We assessed gender differences in the risk of mortality in heart failure (HF) patients and evaluated the association between HF drug treatment and mortality.


RESULTS
We identified a cohort of 820 patients with newly diagnosed HF in 1996 in UK general practices. The diagnosis of HF was confirmed by the general practitioner. Fifty per cent were females and 27% were less than 70 years old. During a mean follow-up of 2 years, 172 patients died. We used computerized records to assess risk factors and drugs prescribed as treatment. The information on severity was assessed through a questionnaire. We performed a nested case-control analysis, and observed that men had twice the risk of dying than females, however the effect of age on mortality was stronger in females than males. We found a similar interaction between HF severity and sex. Data on use of some cardiovascular drugs such as diuretics, beta-blockers ACE-inhibitors and calcium channel blockers were suggestive of a reduced mortality risk. Current use of nitrates and glycosides carried an increased risk.


CONCLUSIONS
Older age, male sex and severity of HF were the main predictors of mortality among HF patients. Long-term use of beta-blockers was associated with a significantly reduced risk of mortality.
Ruigómez
A
A
Centro Español de Investigacíon Farmacoepidemiológica, Madrid, Spain.
Johansson
S
S
Wallander
M A
MA
García Rodríguez
L A
LA
D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000401:mortality*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors
D002317:Cardiovascular Agents