There are considerable differences between men and women when it comes to heart failure. Not only do more men have a form of heart failure that affects the pumping action of the heart than women, but heart failure itself tends to develop at an earlier age. Women have a higher risk of developing heart failure without a decline in the pumping action. Women with chronic heart failure have a better prognosis than men with the same condition. Men and women have an equal chance of developing acute heart failure. These are the results of research carried out by cardiologist Sven Meyer from the University Medical Center Groningen. Meyer will be awarded a PhD by the University of Groningen on 21 September.
Differences between men and women are an essential aspect of individual treatment plans. Understanding the differences between men and women with cardiovascular disease is important in terms of improving the clinical treatment of the disease, and developing new treatments.
Aim of the research
The aim of Meyer’s research was to characterize the differences between men and women with heart failure. People with heart failure suffer a reduction in the pumping action of their heart. The heart does not pump enough blood around the body and patients become tired and retain fluid. Some 140,000 patients in the Netherlands have heart failure. Heart failure can be the result of a diseased heart muscle, known as cardiomyopathy; this is usually associated with structural and functional abnormalities. Certain abnormalities, particularly thickening of the heart muscle, are more common in men than in women.
More men develop heart failure, and at an earlier age
Meyer’s research shows that men more often develop heart failure that involves a reduced pumping action, and at an earlier age. This is generally the result of a heart attack. The most striking discovery is that women tend to develop heart failure much later than men. Women have a higher chance of developing heart failure without a reduction in the pumping action, even when taking the higher age and a number of definite cardiovascular risk factors into account. Meyer proved that atrial fibrillation puts women at a significantly higher risk of developing heart failure.
Better prognosis for women
Meyer studied the clinical characteristics of men and women admitted to hospital with heart failure. His research clearly shows that older female patients with heart failure retain better pumping action of the heart, have fewer restrictions due to diseased coronary arteries, higher blood pressure and show more signs of excessive blood flow than their male counterparts. Women have a better prognosis than men, irrespective of the differences in clinical characteristics. However, there is no clear explanation for the biological background to this higher chance of survival among women. Meyer did show that specific biomarkers that serve as characteristics for various biological processes, such as inflammation, are less prevalent in women’s blood than in that of men.
No gender difference in the case of acute heart failure
In addition to chronic heart failure, Meyer also studied the acute form. His research shows that the risks associated with acute heart failure are similar for men and women. Furthermore, he shows that the findings in hospital and after discharge are also the same for men and women.
According to Meyer, it is strange that certain biomarkers are present in less high concentrations in women with heart failure, despite generally being higher in women. He sees this as a reason for investigating the biological processes that really make the difference between men and women with different types of heart failure.
Sven Meyer (Wildeshausen, Germany, 1977) graduated in medicine at the University of Hannover. He carried out his research in the Thorax Centre of the UMCG. His thesis is entitled: ‘Sex differences in heart failure’. Meyer now works in the Heart Center Oldenburg (Germany) and at the European Medical School Oldenburg-Groningen, a unique collaboration in which Oldenburg and Groningen work together on medical training programmes.
A PhD dissertation consisting of more than 1100 pages and covering a total of 31 chapters. UMCG PhD-candidate Arno Bourgonje (26) probably wrote the most voluminous medical PhD dissertation ever published in the Netherlands.
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