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Gender Disparities (I)

 

1.Men are more likely to present with dyspnea on exertion, fatigue and edema
True     False
2.Women present with a wider range of symptoms than men
True     False
3.Women are more often diagnosed and treated by general practitioners than specialists compared with men
True     False
4.Men and women often receive different levels of investigation with regards to diagnostic tools and procedures
True     False
5.Men are more likely to present with preserved left ventricular systolic function
True     False
6.Men more frequently receive diagnostic work up with exercise stress tests, Holter monitoring, echocardiography and nuclear ventriculograms than women
True     False
References for this Activity
1. Lee WY, Capra AM, Jesvold NG, Gurwitz JH, Go AS, for the Epidemiology, Practice, Outcomes, and Cost of Heart Failure (EPOCH) Study. Gender and Risk of Adverse Outcomes in Heart Failure. Am J Cardiol. 2004;94:1147-1152.
2. Philbin EF, DiSalvo TG.Influence of race and gender on care process, resource use and outcomes in congestive heart failure. Am J Cardiol 1998;82:76-81.
3. Clarke KW, Gray D, Hampton JR.Evidence of inadequate investigation and treatment of patients with heart failure.Br Heart J 1994;71:584-7.
4. Burns RB, McCarthy EP, Moskowitz MA, Ash A, Kane RL, Finch M.Outcomes for older men and women with congestive heart failure.J Am Geriatr Soc 1997;45:276-80.
5. Philbin EF, DiSalvo TG.Influence of race and gender on care process, resource use and outcomes in congestive heart failure. Am J Cardiol 1998;82:76-81.
6. Mejhert M, Holmgren J, Wandell P, Persson H, Edner M. Diagnostic tests, treatment and follow-up in heart failure patients—is there a gender bias in the coherence to guidelines? Eur J Heart Fail 1999;1:407-10.

 

 

Gender Disparities (II)

Women present with a wider range of symptoms than men

 

 

The prevalence of diastolic dysfunction increases with age for women, but not for men [4]

Analysis from the Beta-Blocker Evaluation of Survival Trial (BEST) identified some of the differences in baseline characteristics between men and women with HF [3].

Women had:

  • Higher left ventricle ejection fraction

  • Lower occurrence of atrial fibrillation

  • Higher heart rate

  • Higher cardiothoracic ratio

  • Higher prevalence of left bundle branch block

 

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3. Crabbe DL, Dipla K, Ambati S, Zafeiridis A, Gaughan JP, Houser SP, Margulies KB. Gender differences in post-infarction hypertrophy in end-stage failing hearts. J Am Coll Cardiol 2003;41:300–6.

4. Samuel RS, Hausdorff JM, Wei JY.Congestive heart failure with preserved systolic function: is it a women’s disease? Women’s Health Issues 1999;9:219 –22.

All references for this section