Impact of sex differences in co-morbidities and medication adherence on outcome in 25 776 heart failure patients.
ESC Heart Fail
; 8(1): 63-73, 2021 02.
Article
en En
| MEDLINE
| ID: mdl-33247631
ABSTRACT
AIMS:
Health insurance claims (HIC) databases in the Netherlands capture unselected patient populations, which makes them suitable for epidemiological research on sex differences. Based on a HIC database, we aimed to reveal sex differences in heart failure (HF) outcomes, with particular focus on co-morbidities and medication. METHODS ANDRESULTS:
The Achmea HIC database included 14 517 men and 11 259 (45%) women with a diagnosis treatment code for chronic HF by January 2015. We related their sex, co-morbidities, and medication adherence (medication possession rate >0.8) with the primary endpoint (PE) of all-cause mortality or HF admission during a median follow-up of 3.3 years, using Cox regression. Median age of men and women was 72 and 76 years, respectively. Prevalence of co-morbidities and use of disease-modifying drugs was higher in men; however, medication adherence was similar. At the end of follow-up, 35.1% men and 31.8% women had reached the PE. The adjusted hazard ratio for men was 1.25 (95% confidence interval 1.19-1.30). A broad range of co-morbidities was associated with the PE. Overall, these associations were stronger in women than in men, particularly for renal insufficiency, chronic obstructive pulmonary disease/asthma, and diabetes. Non-adherence to disease-modifying drugs was related with a higher incidence of the PE, with similar effects between sexes.CONCLUSIONS:
In a representative sample of the Dutch population, as captured in a HIC database, men with chronic HF had a 25% higher incidence of death or HF admission than women. The impact of co-morbidities on the outcome was sex dependent, while medication adherence was not.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Caracteres Sexuales
/
Insuficiencia Cardíaca
Tipo de estudio:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
ESC Heart Fail
Año:
2021
Tipo del documento:
Article
País de afiliación:
Países Bajos