FEMALE GENDER AND HEART FAILURE. MORE DATA

We are beginning to learn more about female hearts and how they behave, especially when they are failing. Dr Manuel Selles and colleagues from Madrid, Spain, did a nice meta-analysis of females with heart failure and compared them with males. This study was published in the March 8th edition of the European Journal of Heart failure. They looked into 31 large studies of heart failure, with a total of about 42,000 patients, trying to see if there were any differences in presentation and survival. They called theirs the MAGGIC ( Meta-analysis Global Group in Chronic Heart Failure ) study. There were 28,052 males and 13,897 females in the whole meta-analysis. The very large numbers allowed them to find fine differences and see if they are significant. After 3 years of follow-up, 25% of females and 26% of males died. They found this to be significant. Most of the males had ischemic heart disease as their cause of heart failure from LV systolic dysfunction. In females, the heart failure were mostly from hypertension and LV diastolic dysfunction. For the same degree of LV dysfunction, more males died than females. Also, in diabetes, these difference between male and female survival was less. Females were also older when they died.
Looks like for equivalent amount of heart disease, females cope better then males. Why this is so is less obvious. There are many theories, ranging from females having a stronger heart, to having lesser CAD, to stronger RV function in females and better LV remodelling after a heart attack. Basically, we are not sure.
Suffice to say that females have an advantage in survival should they develop heart failure.