Heart failure

Women With HF Have Higher Mortality Rate After 1 Year

The mortality rate in patients with heart failure (HF) is high in the ambulatory setting, especially among women, according to findings of a new study.

“At a time when heart failure management has greatly improved, detailed [gender]-stratified outcomes are scarce in hospital-admitted cohorts and unavailable in ambulatory patients,” the researchers write. “Given the [gender] differences in comorbidities and outcomes in heart failure, it is not known whether and how these current changes are modified by [male or female status]. An in-depth understanding of these [...] differences may help to increase awareness and lead to clinical trials to identify optimal monitoring and treatment strategies in women and men.”


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The differences between men and women in HF incidence, mortality, and hospital admission were assessed in all Ontario residents aged 40 years or older who were diagnosed with HF in an ambulatory care setting between April 2009 and April 2014 (N = 90,707).

Physician billing codes were used to record incident HF cases, and primary outcomes included mortality rate and hospital admission rate for HF after 1-year post-diagnosis.

Women comprised 47% of the total study participants; they were more likely to be older and frailer than men.

Findings from the analysis include:

  • Overall, the incidence of HF decreased among both men and women during the study period.
  • The 1-year post-diagnosis mortality rate decreased overall but was higher among women.
  • In 2009, the age-standardized rate for hospital admission for HF was higher in men; however, by 2013, the hospital admission rate was higher in women.

“Despite decreases in overall heart failure incidence and mortality in ambulatory patients, mortality rates remain higher in women than in men, and rates of hospital admission for heart failure increased in women and declined in men,” the researchers concluded.

“Further studies should focus on [gender] differences in health-seeking behavior, medical therapy, and response to therapy to provide guidance for personalized care.”

—Amanda Balbi


  1. Sun LY, Tu JV, Coutinho T, et al. [...] differences in outcomes of heart failure in an ambulatory, population-based cohort from 2009 to 2013 [published online July 16, 2018]. CMAJ. https://doi.org/10.1503/cmaj.180177.



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