Resumen
Background: Heart failure is a global phenomenon with poor morbi-mortality statistics. Though data abound in the developed nations, they are just becoming available here. There is a perceived neglect of heart failure epidemiology as it affects women; which is getting some attention in the advanced nations. This work attempts to see how gender impacts on heart failure in our environment and to provide insight on how any peculiarities could be approached.
Method: As part of a larger study on relationship between 6 minute walk test and left ventricular systolic function in heart failure patients in our centre (July 2012 to June 2013), we dichotomized the cases along the line of gender. This was to see what differences may be related to the genders. All patients had history, physical examination and investigations including echocardiography which formed the bases for comparison.
Results: There were 140 patients, 85 (60.7%) of whom were females. Mean age was 48.2(14.5) years; but males were significantly older [53.8(12.6) Vs 44.6(14.6)]. Heart failure under 45 years affected women more. More males drank and smoked. While diabetes was more common in males, more females had hypertension and rheumatic heart disease as aetiologies. Females tended to be more symptomatic but the difference did not attain statistical significance. Renal function tended to be worse in males.
Conclusion: Women tend to go into heart failure earlier than men in our environment and had more hypertension andrheumatic heart disease as causes. Renal function was worse in males given a greater constellation of cardiovascular disease risk factors namely alcohol use, smoking and diabetes. More effort should go into preventing rheumatic heart disease and hypertension which result in heart failure in women. Obstetric encounters for cerebrovascular disease evaluation should be taken more seriously since these conditions are likely to result in failure related to pregnancy and child-birth.
Keywords: Heart failure, gender, differences, Nigeria.
Résumé
Contexte: L’affaiblissement cardiaque est un phénomène mondial avec statistiques pauvres en morbidité et mortalité. Bien que les données abondent dans les pays développés, elles sont justes en train de devenir disponible ici. Il y a une perçue négligence de l’épidémiologie de l’affaiblissement cardiaque comme il affecte les femmes; ce qui gagne une certaine attention dans les pays avancés. Ce travail tente de voir l’impact du genre sur l’affaiblissement cardiaque dans notre environnement et pour donner un aperçu sur la façon dont les particularités pourraient être approchées.
Méthode: Dans le cadre d’une vaste étude sur la relation entre le test de six minutes de marche et la fonction systolique du ventricule gauche chez des patients avec affaiblissement cardiaque dans notre centre (Juillet 2012 au Juin 2013), nous avons dichotomisé les cas le long de la ligne du genre. Ceci fut pour voir quelles différences peuvent être liées aux genres. Tous les patients avaient histoire, examen physique et enquêtes y compris l’échocardiographie qui a formé les bases de comparaison.
Résultats: Il y avait 140 patients, 85 (60,7%) d’entre eux étaient des femmes. L’âge moyen était de 48,2 (14,5) ans; mais les hommes étaient significativement plus âgés [53,8 (12,6) Vs 44,6 (14,6)]. L’affaiblissement cardiaque en dessous de 45 ans a plus touché les femmes. Plus d’hommes buvaient et fumaient. Bien que le diabète fût plus fréquent chez les hommes, plus de femmes ont eu l’hypertension et la maladie rhumatismale du cœur comme étiologies. Les femmes ont tendance à être plus symptomatiques, mais la différence n’a pas atteignis la signifiance statistique. La fonction rénale a eu tendance à être pire chez les hommes.
Conclusion: Les femmes ont tendance à avoir l’affaiblissement cardiaque tôt que les hommes dans notre environnement et avaient de plus l’hypertension et la cardiopathie rhumatismale comme causes. La fonction rénale était pire chez les hommes du à une plus grande constellation de facteurs risque cardiovasculaire de la maladie à savoir la consommation d’alcool, le tabagisme et le diabète. Plus d’efforts doivent être fournies dans la prévention des cardiopathies rhumatismales et l’hypertension qui résultent à l’affaiblissement cardiaque chez les femmes. Rencontres obstétricales pour l’évaluation de la maladie cérébrovasculaire devraient être prises plus au sérieux puisque ces conditions sont susceptibles d’entraîner une défaillance liée à la grossesse et l’accouchement.
Mots-clés: affaiblissement cardiaque, genre, différences, Nigeria.
Correspondence: Prof. B.N. Okeahialam, Cardiology Unit 1, Department of Medicine, Jos University Teaching Hospital, Jos Plateau State, Nigeria. E-mail: basokeam@yahoo.com
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