Heart Failure With Preserved Ejection Fraction In Women: Insights From The National Inpatient Sample Database

• Published in: Journal of cardiac failure Vol. 30; no. 1; pp. 205 - 206
• Main Authors: Singh, Amninder, Khurana, Sumit, Sachdeva, Sonali, Maligireddy, Anand Reddy, Khandait, Harshwardhan, Bindra, Bikramjit Singh
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-01-2024
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2023.10.215

Heart failure with preserved ejection fraction (HFpEF) patients account for over half of all heart failure (HF) hospitalizations, and the proportion is estimated to increase in the coming years. The age-adjusted prevalence of HFpEF has been found to be similar in men and women in small community-based studies. However, there is a lack of large-scale analysis of the prevalence and associated comorbidities of HFpEF in women.
The authors postulated that there are significant differences in the inpatient prevalence, characteristics, and outcomes of female patients with HFpEF as compared to their male counterparts.
The study analyzed data from the National Inpatient Sample (NIS) database from 2017 to 2020 on adults aged 18 years and above. The study aimed to assess gender-based differences in in-hospital mortality, length of stay, cost of hospitalization, and associated comorbidities.
Of the 1.47 million HFpEF patients in the sample, 59% were females, and the majority of the patients were aged 60 years or higher, with approximately 35% of people aged over 80 years. Hyperlipidemia, atrial fibrillation, and obesity were significantly associated comorbidities in patients with HFpEF. After matching, the study found that female patients had similar in-hospital mortality (OR 1.012, CI 0.99 - 1.03, p < 0.001) and a shorter length of stay (mean 5.97 vs. 6.42 days, p < 0.001) and lower cost of hospitalization (mean $64933.99 vs. $77742.63, p < 0.001) compared to male patients.
In patients with HFpEF, female gender was associated with a shorter length of stay and lower cost of hospitalization after adjustment for race, age, and chronic comorbidities. This study highlights the high prevalence of HFpEF in female patients and identifies the associated comorbidities. These observations emphasize the importance of further research on pathogenesis and underlying risk factors, especially in women, to potentially reduce the burden of HFpEF in the elderly population.