Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study
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 h...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-021-10442-3 |
| _version_ | 1818615559324958720 |
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| author | Giulia Cesaroni Gian Francesco Mureddu Nera Agabiti Flavia Mayer Massimo Stafoggia Francesco Forastiere Roberto Latini Serge Masson Marina Davoli Alessandro Boccanelli on behalf of the PREDICTOR Study Group |
| author_facet | Giulia Cesaroni Gian Francesco Mureddu Nera Agabiti Flavia Mayer Massimo Stafoggia Francesco Forastiere Roberto Latini Serge Masson Marina Davoli Alessandro Boccanelli on behalf of the PREDICTOR Study Group |
| author_sort | Giulia Cesaroni |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T16:35:50Z |
| format | Article |
| id | doaj.art-848f0c36122a44ca816dfaa108398a65 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-16T16:35:50Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-848f0c36122a44ca816dfaa108398a652022-12-21T22:24:29ZengBMCBMC Public Health1471-24582021-02-0121111310.1186/s12889-021-10442-3Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based studyGiulia Cesaroni0Gian Francesco Mureddu1Nera Agabiti2Flavia Mayer3Massimo Stafoggia4Francesco Forastiere5Roberto Latini6Serge Masson7Marina Davoli8Alessandro Boccanelli9on behalf of the PREDICTOR Study GroupDepartment of Epidemiology - Regional Health ServiceCardiology and Cardiovascular Rehabilitation Unit, S. Giovanni-Addolorata HospitalDepartment of Epidemiology - Regional Health ServiceNational Center for Disease Prevention and Health Promotion, National Institute of HealthDepartment of Epidemiology - Regional Health ServiceDepartment of Epidemiology - Regional Health ServiceMario Negri Institute for Pharmacological Research – IRCCSMario Negri Institute for Pharmacological Research – IRCCSDepartment of Epidemiology - Regional Health ServiceQuisisana ClinicAbstract 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.https://doi.org/10.1186/s12889-021-10442-3Heart failureDiastolic left ventricular dysfunctionSex differencesRisk factorsElderlyNT-proBNP |
| spellingShingle | Giulia Cesaroni Gian Francesco Mureddu Nera Agabiti Flavia Mayer Massimo Stafoggia Francesco Forastiere Roberto Latini Serge Masson Marina Davoli Alessandro Boccanelli on behalf of the PREDICTOR Study Group Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study BMC Public Health Heart failure Diastolic left ventricular dysfunction Sex differences Risk factors Elderly NT-proBNP |
| title | Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study |
| title_full | Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study |
| title_fullStr | Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study |
| title_full_unstemmed | Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study |
| title_short | Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study |
| title_sort | sex differences in factors associated with heart failure and diastolic left ventricular dysfunction a cross sectional population based study |
| topic | Heart failure Diastolic left ventricular dysfunction Sex differences Risk factors Elderly NT-proBNP |
| url | https://doi.org/10.1186/s12889-021-10442-3 |
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