Sex Differences in Heart Failure Symptoms and Factors Associated With Heart Failure Symptoms

Abstract

Background: A majority of patients with heart failure (HF) experience HF symptoms. Some literature suggests sex differences in the status of and also factors associated with HF symptoms. However, information on common HF symptom status and factors associated with HF symptoms in male and female patients is scarce. Objectives: The aim of this study was to examine HF symptom status and factors associated with HF symptoms in male and female patients with HF. Methods: Descriptive data on HF symptoms, psychological factors (depressive symptoms and perceived control), sociodemographic factors (age and sex), clinical factors (body mass index, comorbidities, medication, and left ventricular ejection fraction), and a behavioral factor (self-care) were collected in 70 male and 49 female patients with HF. Mann-Whitney U tests, chi(2) tests, and stepwise regression models were used to address the objectives. Results: Fatigue was the most common HF symptom in both sexes, but male patients had less severe HF symptoms, including frequency, severity, and/or distress. In male patients, 2 psychological and 2 clinical factors (comorbidities and use of diuretics) were significantly associated with HF symptoms (adjusted R-2 = 0.669, P ˂.001), whereas in female patients, only depressive symptoms were significantly associated with HF symptoms (adjusted Fe = 0.679, P ˂.001). Discussion: There were sex differences in HF symptoms and the factors associated with HF symptoms. Clinicians and researchers need to recognize and manage psychological factors in both sexes and clinical factors in male patients by using effective interventions to improve HF symptoms.