By CAROL HENDERSON
UNC News Services
CHAPEL HILL -- Women who suffer from a common form of heart failure live longer than men with the same condition, according to a new University of North Carolina in Chapel Hill study.
UNC-CH School of Medicine researchers compiled mortality rates from 557 patients with heart failure referred to the university's Heart Failure Program. After two and a half years follow-up, women were significantly more likely to survive than men, even after accounting for differences in age, heart function and other factors. A report on the study appears in the December issue of the Journal of the American College of Cardiology.
"There's a good biological foundation suggesting that hearts of men and women react differently to heart failure," said Dr. Kirkwood F. Adams, assistant professor of medicine and director of the heart program. "We're hoping to do further research to find out why."
All differences between men and women occurred in patients who suffered heart failure due to what are called non-ischemic causes. High blood pressure, alcohol abuse and valve disease are among the causes of that form of failure.
Ischemic heart failure, on the other hand, produces insufficient blood and oxygen flow and results from a heart attack caused by a narrowed coronary artery that has become blocked.
Women were just as likely as men to die prematurely when they suffered ischemia. In the non-ischemic group, however, men were more than twice as likely to die early as women.
Adams and colleagues credit the program's unique data base for helping them discover the gender differences. Most heart failure data bases are predominantly male and ischemic, the physician said. In the UNC-CH study, nearly a third of the subjects were female, and more than two-thirds of the total group suffered non-ischemic heart failure.
"We treat a large number of non-ischemic heart failure patients seeking heart transplants at UNC," Adams said. "Because we're not only involved in clinical trials but also serve as a comprehensive clinical care center, we have a more diverse population that includes many women and other minorities. In fact, nearly 50 percent of our study population was non-Caucasian."
Adams said it is important to include more women in clinical trials where new treatments for heart failure are being developed, especially since women seem to react differently to heart failure and also could respond differently to drugs and other treatment.
Although many biological differences exist between the sexes, non-biological reasons may explain women's increased survival rates. Women mignt seek medical assistance earlier than men, be more inclined to return for clinic visits and be more likely to take their medications.
"The differences we're seeing between genders is probably a mixture of biology and psychosocial factors like compliance," Adams said. "We need to understand what it is about females that makes them survive better and adapt better to their heart failure."
Patient follow-up at the UNC-CH program is ongoing and lasts considerably longer than in most clinical trials, Adams said.
"Our patient data base now goes back almost 10 years," he said. "We're excited about the impact our long-range findings could have on clinical treatments. Once we understand why women fare better, we might be able to change outcomes for everybody."
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Note: Adams can be reached at (919) 966-4445
Contact: David Williamson