אי ספיקת לב ופרפור פרוזדורים - מגדר

- " . ,

Heart Disease and Stroke Statistics 2009 Update Donald Lloyd-Jones

Prevalence of heart failure by age and sex NHANES: 2005-2006Source: NCHS and NHLBI

Chart1

0.10.2

2.21.2

9.34.8

13.812.2

Men

Women

Percent of Population

DEATHSCHF

Deaths From CHF, United States: 1979-98 (428.0)

(000)Congestive

Ht. Failuremalesfemaleswmwfbmbf

197920

8022

8123

8225

83271116101411411712511573

84291217109011532913031708

85321319114801684914181841

86341420124511812714591989

87351421125571916114661949

88371522132872014115672109

89341321119031870014082056

90341321118251871613971931

91351422121191963713331999

92361422124682030013351963

93421626142322351814772246

94421626141492354614192119

95431627145952436714652217

96441727

97451728

98471829comp. Ratio

9951193248,8221.041

0052193249,516

0153203350,747

Deaths From Congestive Heart Failure

United States: 1979-97

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DEATHSCHF

Congestive Ht. Failure

Years

Deaths in Thousands

PCTCHGCHF

Congestive Heart Failure % Increase in Deaths

CHF

7919.936

8021.804

8123.297

8225.09

8327.274

8429.429

8531.807

8634.271

8735.387

8837.371

8934.348

9034.156

9135.393

9236.387

9341.819

9441.601

9543.01

9643.837

119.8886436597

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HFPREV

HF PREVALENCE

MenWomen

20-390.10.2

40-592.21.2

60-799.34.8

80+13.812.2

Prevalence of Heart Failure by Age and Sex


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HFPREV

Men

Women

Percent of Population

Note: Hospital discharges include people discharged alive, dead and status unknownHospital discharges for heart failure by sex United States: 1979-2006Source: NHDS/NCHS and NHLBI

Chart1

185.303214.49

190.125240.37

258.645326.377

324.63397.288

383.917496.515

421.896585.791

523583

Male

Female

Years

Discharges in Thousands

CVD

CVD (390-459)Hdis.MalesFemalesHospital Discharges* for Cardiovascular Diseases as First listed Diagnosis

703.34United States: 1970-2006

3.543

3.86

4.11

4.304

754.418

4.585

4.758

4.766

4.907792.4712.436

805.14802.592.549

5.336812.6792.657

5.4882.7852.703

5.6542.8962.758

5.5932.8562.737

855.47852.7832.686

5.5632.8462.717

5.5722.8682.704

5.2962.7222.574

5.1972.672.527

905.161902.6682.493

5.3382.7282.611703.34

5.5972.8662.73754.418

5.6332.8852.747805.14

5.7792.9062.873855.47

955.83952.9732.857905.161

6.1073.1013.006955.83

6.0973.1163.03006.294

6.272983.1393.133066.161

6.344794.907

006.2943.1153.179805.14

6.2263.0583.168815.336

6.3733.2093.164825.488

6.4343,2393.196835.654

6.3633.2273.136845.593

056.1593.1363.023855.47

066.1613.1213.04865.563

875.572

885.296

895.197

905.161

915.338

925.597

935.633

945.779

955.83

966.107

976.097

NOTE: do not include congenital!986.272

996.344

006.294

Neoplams 140-4591.61.631

Endocrine System 240-2791.71.663

Musculoskeletal System 710-7392.01.969

Genitourinary System 580-6292.01.974

Mental 290-3192.42.419

External: Injuries, etc. 800-9993.02.968

Respiratory System 460-5193.53.485

Digestive System 520-5793.53.517

Obstetrical V274.14.127

Cardiovascular 340-4596.26.161

Chart 2-20. Hospital Discharges for the 10 Leading Diagnostic Groups

United States: 2006

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CVD

0

0

0

0

0

0

0

0

Years

Discharges in Millions

stroke

Hospital Discharges Where Stroke Was the First Listed Diagnosis

United States: 1979 to Date

YearMalesFemalesTotal

79335411746

80371425796

368439807

388446834

407469876

420477897

85407499906

398491889

392503895

336448784

344447791

90355453808

371464835

376450826

387452839

407478885

95424501925

438518956

4615551017

4575531010

434527961

00428553981

391539931

432509942

455510965

416490906

05418477895

06404486889

Hospital Discharges Where Stroke Was the First Listed Diagnosis


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stroke

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

Males

Females

Years


CHF

Hospital Discharges for CHF

CHF Discharges

-----------In thousands------

MalesFemalesTotal

708074155

7986165

98102200

107111218

121113234

75122131253

123143267

143152296

157173330

174203377

80176224401

182240423

195243439

208255464

228303531

85247310557

274308582

269336605

277357634

304339643

90315386701

360405764

373449822

394481875

390484874

95378494872

377493870

431526957

438540978

430532962

00418581999

444551995

441529970

4715661,037

04

Hospital Discharges*for Congestive Heart Failure by Sex


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CHF

1

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#REF!


HF

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

Males

Females

Years


HBP

Hospital Discharge Code=428 FL (1970-2003) Heart Failure

MaleFemale

197011,07111,238

9,5199,157

10,4909,276

9,42910,090

8,9249,555

7510,3259,056

7,4888,974

6,2617,660

5,3346,539

MaleFemale

79185214

80190240

195252

207257Hospital discharges for Heart Failure by Sex

221276United States: 1979-2006MaleFemale

23731779185214

8525932680190240

28732885259326

28234790325397

28937595384497

31235100422586

9032539706523583

370417

384456

404491

395492

95384497

381496

436530

442547

434541

00422586

446554

443530

496597

05494590

06523583

HBP

00

00

00

00

00

00

00

Male

Female

Years


chd

Hospital Discharges Where HBP Was the First-Listed DiagnosisHospital Discharges Where HBP Was the All-Listed Diagnosis

United States: 1979 to Date (000)United States: 1979 to Date (000)

MalesFemalesTotalMalesFemalesTotal

19901221642851990163422303864

129190317178625204305

9215321336792200427834788

176208383223230235255

9415122137394234832505599

174200384244133605807

9617124641796262535486178

173250422277838596639

9817126643798295041967146

172267439319844367640

0018627145700330247328043

194292486396854059375

0222431253502396854059375

221299520424056419885

04230322551044500596510473

05215284499054648599910653

First-Listed Hospital Discharges for Hypertension by SexAll-Listed Hospital Discharges for Hypertension by Sex

United States 1990-2005United States 1990-2005

chd

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

Males

Females

Years


00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

00

Males

Females

Years


Hospital Discharges Where CHD Was the First Listed Diagnosis


(000)(000)

YearMalesFemales

70779597

851628

935693

982725

1030756

751043789

1087843

1111852

1110844

10147241738

801049737

1095765

1160841

1229852

1044840

851205846

1250889

1268901

1220830

1174819

901151795

1146806

1247886

1205872

1219899

9512698582127

1325933

1249840

1263915

1317945

001274892

1199891

1249875

1175834

11808011981

0511177111828

0610567041760

Hospital Discharges for Coronary Heart Diasease by SexYearMalesFemales

United States: 1970-200670779597

751043789

801107795

851226864sent by Maria Owings 9/19/08

901159806

951271865

001277896

061056706

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00

00

00

00

00

00

00

00

Males

Females

Years


MBD0012E4D4.xls

Chart9

1.6

1.7

2

2

2.4

3

3.5

3.5

4.1

6.2


Sheet1

Neoplams 140-4591.61.631

Endocrine System 240-2791.71.663

Musculoskeletal System 710-7392.01.969

Genitourinary System 580-6292.01.974

Mental 290-3192.42.419

External: Injuries, etc. 800-9993.02.968



Obstetrical V274.14.127


Chart 2-20. Hospital Discharges for the 10 Leading Diagnostic Groups

United States: 2006

Hemic and Lymphatic 40-410.40.371

Urinary System 55-591.01.025

Nervous System 01-051.21.155


Integumentary System 85-861.61.598

Female Genital Organs 65-712.01.957

Musculoskeletal 76-844.24.188



Obstetrical 72-757.17.076

Chart 18-3. Number of Surgical Procedures in the 10 Leading Diagnostic Groups

United States: 2006

Sheet1

1.6

1.7

2

2

2.4

3

3.5

3.5

4.1

6.2


Sheet2

0.4

1

1.2

1.2

1.6

2

4.2

5.6

6.5

7.1

Millions of Discharges

Sheet3

Gender Differences in the Management and Outcome of Patients Hospitalized with Heart Failure in HFSIS 2003

E. Cohen, M. Garty, A. Shotan, BS. Lewis, C. Rachima-Maoz, A. Porath, A. Sandach, M. Moriel, S. Behar, A. Caspi, and S. GottliebFor the Steering Committee and Investigators of HFSIS 2003

HFSIS Heart Failure Survey in Israel 2003 25/25 Hospitals 93/98 Internal Medicine Departments 24/25 Cardiology Departments (24 ICCU, 16 Intermediate) 4872 Hospitalizations recorded

4514 Hospitalizations

4102 PatientsStudy Population

4102 PatientsMen2339 Patients57%Women1763 Patients43%71.5 12.4 yrs 73.4 12.2 yrs 75.9 11.4 yrsHFSIS 2003 Age by Gender

HFSIS 2003 Clinical Characteristics Men(n=2338)%

71.5 12.44371483038 46* 88* 40*

Women (n=1764)%

75.9 11.4* 59* 81* 53* 38* 54*34 7532

Age, yrs (m SD) >75 yearsHypertensionDiabetesAtrial fib. Anemia (Hb 1.5 mg/dl)IHDACS*P

HFSIS 2003 Functional Class and Type of HFMen(n=2338) %

3638465714 61*

Women (n=1764)% 43* 48* 54* 60* 29* 39

NYHA Class III/IVKiIlip Class III/IVPrimary diagnosis HFAcute decompensated HFDiastolic HFLVEF

HFSIS 2003 Acute Management%***P

HFSIS 2003 Medications at Discharge%* P

HFSIS 2003 MortalityMen(n=2338)

3.6%

Women (n=1764)

6.2%*

In-hospital Mortality: Crude Unadjusted OR (95%CI) Age-adjusted OR Covariate adjusted OR1-year Mortality: Crude Unadjusted OR (95%CI) Age-adjusted OR Covariate adjusted OR

*P=0.0001; **P=0.02; OR women vs. men; Adjusted for: age, DM, HBP, Renal failure (Cr>1.5mg%), anemia (Hb

Men

SBP

HFSIS 2003 Variables Associated with 1-year MortalityMen

1.43 (1.30-1.58)2.09 (1.70-2.58)2.08 (1.63-2.69)1.58 (1.28-1.95)1.53 (1.24-1.91)0.70 (0.56-0.88)1.37 (1.08-1.72)1.43 (1.07-1.97)1.22 (0.99-1.51)1.18 (0.95-1.46)

Age (10-yr increm.)NYHA III-IVSBP

HFSIS 2003 Variables Associated with 1-year Mortality Women

1.52 (1.36-1.71)2.23 (1.65-3.01)1.97 (1.56-2.49)1.87 (1.49-2.35)1.62 (1.17-2.22)1.24 (0.98-1.56)1.15 (0.92-1.41)

Age (10-yr increm.)SBP 1.5mg%)NYHA III-IVStrokeAnemia (Hb

Men

AgeNYHA III-IVSBP

HFSIS 2003 Crude (A) and Age-adjusted (B) Mortality ABP(LOG RANK) = 0.394P(LOG RANK) = 0.079

HFSIS 2003 Cox Age-adjusted Mortality by Gender and LVEF AB(M,EF=40% vs. W,EF 40) p=0.43(W,EF

HFSIS 2003 AF

HFSIS 2003 AF Baseline Characteristics

In HFSIS 2003 national survey of hospitalized HF patients, women were older than men and had more comorbidities.

Women had worse presentation than men despite a better LVEF.

Use of ACE-I/ARB, spironolactone, and digitalis was similar in women and men. However, women received less often -blockers, aspirin and statins, but more diuretics and CCB..

In-hospital crude mortality was 2-fold higher in women than in men, a difference that disappeared at 1-year.

Gender disparities in outcome most probably relate to womens older age, differences in HF etiology and presentation.HFSIS 2003 Conclusions

- , , ': ,

Uri Elkayam, MD Chairman Avraham Shotan, MD C0-Chairman

אי ספיקת לב ופרפור פרוזדורים - מגדר

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