In Some Matters of the Heart Women Have the Edge

	Women with advanced CHF may live twice as
long as their male counterparts, according to a 
study in Circulation: Journal of the American 
Heart Association. Researcher Kirkwood Adams Jr,
MD, at the University of North Carolina, says 
that a woman has a survival advantage even if her
CHF is as severe as a man's and she has had the 
disease for the same amount of time.
	The study challenges previous research
suggesting that the survival advantage of women 
with CHF might be due to differences in the 
treatment they receive and the length of time 
they had the disease.
	"Our analysis suggests that increased 
survival is strongest among patients whose CHF 
is not due to ischemia, or lack of blood supply to
the heart," says Adams.
	The study used data from the Flolan 
International Randomized Survival Trial (FIRST), 
which included 359 men and 112 women with end-
stage - class 4 - heart failure. After eliminating
patients for whom baseline data were not available,
survival data on 331 men and 99 women were compared.
	Researchers compared groups that were 
similar in almost all respects. Men with non-
ischemic heart disease were 3 times more likely than 
females to die during the first 1 1/2 years. Men 
with ischemic heart disease were 1 1/2 times more 
likely to die during that period.
	Overall, males whose CHF was caused by high 
blood pressure and other factors were twice as 
likely to die as their female counterparts.
	However, the researchers caution that larger
studies are needed to explore mechanisms of 
differences in survival between the sexes.

April 12, 1999
American Heart Association Journal