Sex Differences in Comorbidity, Therapy, and Health Services’ Use of Heart Failure in Spain: Evidence from Real-World Data

Anyuli Gracia Gutiérrez, Beatriz Poblador-Plou, Alexandra Prados-Torres, Fernando J Ruiz Laiglesia and Antonio Gimeno-Miguel
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Anyuli Gracia Gutiérrez: Research Group on Heart Failure, IIS Aragón, Internal Medicine Service, Hospital General de la Defensa, 50009 Zaragoza, Spain
Beatriz Poblador-Plou: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Alexandra Prados-Torres: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain
Fernando J Ruiz Laiglesia: Research Group on Heart Failure, Faculty of Medicine, Internal Medicine Service, Lozano Blesa University Hospital, 50009 Zaragoza, Spain
Antonio Gimeno-Miguel: EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, REDISSEC, Miguel Servet University Hospital, 50009 Zaragoza, Spain

IJERPH, 2020, vol. 17, issue 6, 1-13

Abstract: Heart failure (HF) is becoming increasingly prevalent and affects both men and women. However, women have traditionally been underrepresented in HF clinical trials. In this study, we aimed to analyze sex differences in the comorbidity, therapy, and health services’ use of HF patients. We conducted a cross-sectional study in Aragón (Spain) and described the characteristics of 17,516 patients with HF. Women were more frequent (57.4 vs. 42.6%, p < 0.001) and older (83 vs. 80 years, p < 0.001) than men, and presented a 33% lower risk of 1-year mortality ( p < 0.001). Both sexes showed similar disease burdens, and 80% suffered six or more diseases. Some comorbidities were clearly sex-specific, such as arthritis, depression, and hypothyroidism in women, and arrhythmias, ischemic heart disease, and COPD in men. Men were more frequently anti-aggregated and anti-coagulated and received more angiotensin-converting-enzyme (ACE) inhibitors and beta-blockers, whereas women had more angiotensin II antagonists, antiinflammatories, antidepressants, and thyroid hormones dispensed. Men were admitted to specialists (79.0 vs. 70.6%, p < 0.001), hospital (47.0 vs. 38.1%, p < 0.001), and emergency services (57.6 vs. 52.7%, p < 0.001) more frequently than women. Our results highlight the need to conduct future studies to confirm the existence of these differences and of developing separate HF management guidelines for men and women that take into account their sex-specific comorbidity.

Keywords: Heart failure; epidemiology; comorbidity; medication; health services use; sex; gender (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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