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Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study

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Abstract

Background

The impact of gender on the clinical characteristics, risk factors, co-morbidities, etiology, treatment and outcome of acute heart failure in sub-Saharan Africa has not been described before. The aim of this study was to evaluate the sex diffe rences in acute heart failure in sub-Saharan Africa using the data from The sub-Saharan Africa Survey of Heart Failure (THESUS-HF).

Methods and results

1,006 subjects were recruited into this prospective multicenter, international observational heart failure survey. The mean age of total population was 52.4 years (54.0 years for men and 50.7 years for women). The men were significantly older (p = 0.0045). Men also presented in poorer NYHA functional class (III and IV), p = 0.0364). Cigarette smoking and high blood pressure were significantly commoner in men (17.3 vs. 2.6 % and 60.0 vs. 51.0 % respectively). On the other hand, atrial fibrillation and valvular heart disease were significantly more frequent in women. The mean hemoglobin concentration was lower in women compared to men (11.7 vs. 12.6 g/dl, p ≤ 0.0001), while the blood urea and creatinine levels were higher in men (p < 0.0001). LV systolic dysfunctional was also seen more in men. Men also had higher E/A ratio indicating higher LV filling pressure. Outcomes were similar in both sexes.

Conclusions

Although the outcome of patients admitted for AHF in sub-Saharan regions is similar in men and women, some gender differences are apparent suggesting that in men more emphasis should be put on modifiable life risk factors, while in women prevention of rheumatic heart diseases and improved nutrition should be addressed vigorously.

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Acknowledgments

We want to thank all the health workers who contributed in no small way to the success of this work.

Conflict of interest

None.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, University College Hospital, Ibadan, 5116, Nigeria

    Okechukwu S. Ogah

  2. Soweto Cardiovascular Research Unit, University of the Witwatersrand, Johannesburg, South Africa

    Okechukwu S. Ogah & Karen Sliwa

  3. Momentum Research, Inc, 3100 Tower Boulevard, Suite 801, Durham, NC, 27707, USA

    Beth A. Davison, Christopher Edwards & Gad Cotter

  4. Department of Medicine, Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa and the Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa

    Karen Sliwa

  5. Department of Medicine, Faculty of Medicine, GF Jooste and Groote Schuur Hospitals, University of Cape Town, Cape Town, South Africa

    Bongani M. Mayosi & Neshaad Schrueder

  6. Division of Cardiology, Department of Medicine, Eduardo Mondlane University, Maputo, Mozambique

    Albertino Damasceno

  7. Department of Medicine, Bayero University Kano/Aminu Kano Teaching Hospital, Kano, Nigeria

    Mahmoud U. Sani

  8. Uganda Heart Institute, Kampala, Uganda

    Charles Mondo

  9. Department of Internal Medicine, Buea Faculty of Health Sciences, Cardiology Unit, Douala General Hospital, Douala, Cameroon

    Anastase Dzudie & Charles Kouam

  10. Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria

    Dike B. Ojji

  11. Faculty of Medicine, University of Khartoum, Khartoum, Sudan

    Ahmed Suliman

  12. Department of Medicine, Aga Khan University, Nairobi, Kenya

    Gerald Yonga

  13. Service de Cardiologie, Faculte de medecine de Dakar, Ibadan, 5116, Nigeria

    Sergine Abdou Ba & Fikru Maru

  14. Addis Cardiac Hospital, Addis Ababa, Ethiopia

    Bekele Alemayehu

Authors
  1. Okechukwu S. Ogah
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  2. Beth A. Davison
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  3. Karen Sliwa
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  4. Bongani M. Mayosi
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  5. Albertino Damasceno
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  6. Mahmoud U. Sani
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  7. Charles Mondo
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  10. Charles Kouam
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  13. Gerald Yonga
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  14. Sergine Abdou Ba
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  15. Fikru Maru
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  16. Bekele Alemayehu
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  17. Christopher Edwards
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  18. Gad Cotter
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Corresponding author

Correspondence to Okechukwu S. Ogah.

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Ogah, O.S., Davison, B.A., Sliwa, K. et al. Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study. Clin Res Cardiol 104, 481–490 (2015). https://doi.org/10.1007/s00392-015-0810-y

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  • DOI: https://doi.org/10.1007/s00392-015-0810-y

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