title: Gender Discrepancy in Diabetic Patients Hospitalized With Heart Failure: Does Age Matter?
abstract: Gender discrepancy in the cardiovascular diseases has been evaluated in several studies. We studied the impact of gender disparity on the presentation and outcome of diabetic heart failure (DHF) patients.
  
  
  
  A retrospective analysis was conducted including all DHF patients admitted to the Heart Hospital between 1991 and 2013. Patients' demographics, presentation, management, and hospital outcomes were analyzed and compared based on gender and age.
  
  
  
  Out of 8266 HF patients, 4684 (56.7%) were diabetic, of whom 1817 (39%) were females. Mean age was comparable in both genders. DHF female patients were more likely to be hypertensive (79% vs. 65%, P = 0.001) and obese (13% vs. 4.6%, P = 0.001). DHF females were less likely to receive beta-blockers and angiotensin-converting-enzyme inhibitors/angiotensinogen-receptor blockers (25% vs. 30%, P = 0.001, 54% vs. 57%, P = 0.01, respectively), but were more likely to be on insulin therapy (21% vs. 16%, P = 0.001). In-hospital atrial fibrillation (P =0.90), ventricular tachycardia (P = 0.07), stroke (P = 0.45), and cardiac arrest (P = 0.26) were comparable. Overall in-hospital mortality was comparable in both genders (P = 0.83). In age ≤50 years, male gender was associated with a 3-fold increase in death (13% vs. 4%, P = 0.01), however, this mortality difference disappeared in DHF patients aged >50 years (P = 0.62).
  
  
  
  In DHF, female gender is characterized by having a high prevalence of metabolic syndrome components. Also, females are more likely to have better Left ventricular ejection fraction but less likely to receive cardiovascular evidence based medications. There is no significant difference in the overall hospital mortality between both genders, however, in the younger age; males have a significantly higher mortality.
authors.affiliation: From the *Department of Cardiology, Clinical Pharmacology, Heart Hospital, Hamad Medical Corporation (HMC), Doha, Qatar; †Department of Clinical Medicine, Weill Cornell Medical School, Qatar; ‡Department of Clinical Research, Trauma Section, HMC, Qatar; §Department of Internal Medicine, Cardiology Section, Ahmed Maher Teaching Hospital, Egypt; ¶Department of Cardiology and Cardiovascular Surgery, and ‖Department of Cardiovascular Research, Heart Hospital, HMC, Qatar.
authors.forename: Shaban
authors.initials: S
authors.lastname: Mohammed
authors.forename: Ayman
authors.initials: A
authors.lastname: El-Menyar
authors.forename: Ihsan M
authors.initials: IM
authors.lastname: Rafie
authors.forename: Hajar A
authors.initials: HA
authors.lastname: AlBinAli
authors.forename: Rajvir
authors.initials: R
authors.lastname: Singh
authors.forename: Jassim
authors.initials: J
authors.lastname: Al Suwaidi
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011780:Qatar / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends