title: Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study.
abstract: BACKGROUND
  The impact of gender on the clinical characteristics, risk factors, co-morbidities, etiology, treatment and outcome of acute heart failure in sub-Saharan Africa has not been described before. The aim of this study was to evaluate the sex differences in acute heart failure in sub-Saharan Africa using the data from The sub-Saharan Africa Survey of Heart Failure (THESUS-HF).
  
  
  RESULTS
  1,006 subjects were recruited into this prospective multicenter, international observational heart failure survey. The mean age of total population was 52.4 years (54.0 years for men and 50.7 years for women). The men were significantly older (p = 0.0045). Men also presented in poorer NYHA functional class (III and IV), p = 0.0364). Cigarette smoking and high blood pressure were significantly commoner in men (17.3 vs. 2.6% and 60.0 vs. 51.0% respectively). On the other hand, atrial fibrillation and valvular heart disease were significantly more frequent in women. The mean hemoglobin concentration was lower in women compared to men (11.7 vs. 12.6 g/dl, p ≤ 0.0001), while the blood urea and creatinine levels were higher in men (p < 0.0001). LV systolic dysfunctional was also seen more in men. Men also had higher E/A ratio indicating higher LV filling pressure. Outcomes were similar in both sexes.
  
  
  CONCLUSIONS
  Although the outcome of patients admitted for AHF in sub-Saharan regions is similar in men and women, some gender differences are apparent suggesting that in men more emphasis should be put on modifiable life risk factors, while in women prevention of rheumatic heart diseases and improved nutrition should be addressed vigorously.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan, 5116, Nigeria, osogah56156@gmail.com.
authors.forename: Okechukwu S
authors.initials: OS
authors.lastname: Ogah
authors.forename: Beth A
authors.initials: BA
authors.lastname: Davison
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa
authors.forename: Bongani M
authors.initials: BM
authors.lastname: Mayosi
authors.forename: Albertino
authors.initials: A
authors.lastname: Damasceno
authors.forename: Mahmoud U
authors.initials: MU
authors.lastname: Sani
authors.forename: Charles
authors.initials: C
authors.lastname: Mondo
authors.forename: Anastase
authors.initials: A
authors.lastname: Dzudie
authors.forename: Dike B
authors.initials: DB
authors.lastname: Ojji
authors.forename: Charles
authors.initials: C
authors.lastname: Kouam
authors.forename: Ahmed
authors.initials: A
authors.lastname: Suliman
authors.forename: Neshaad
authors.initials: N
authors.lastname: Schrueder
authors.forename: Gerald
authors.initials: G
authors.lastname: Yonga
authors.forename: Sergine Abdou
authors.initials: SA
authors.lastname: Ba
authors.forename: Fikru
authors.initials: F
authors.lastname: Maru
authors.forename: Bekele
authors.initials: B
authors.lastname: Alemayehu
authors.forename: Christopher
authors.initials: C
authors.lastname: Edwards
authors.forename: Gad
authors.initials: G
authors.lastname: Cotter
mesh_terms: D000208:Acute Disease; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*