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Elderly Hospitalized Patients With Diastolic Heart Failure: Lack of Gender and Ethnic Differences in 18-Month Mortality Rates

¹ The Center for Health Equity Research and Promotion, VA Pittsburgh HealthCare System, Pittsburgh, Pennsylvania.
² Department of Bioethics, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Background. Racial and gender differences in mortality rates have been reported for patients with systolic heart failure. Relatively little is known regarding diastolic heart failure prognosis.

Methods. Our sample consisted of 1058 patients 65 years of age or older who were admitted to 30 hospitals in Northeastern Ohio with a principal diagnosis of heart failure and a left ventricular ejection fraction of 50% by echocardiogram.

Results. Of the 1058 patients with diastolic heart failure (13% African American and 87% white), African Americans and whites were comparable with respect to history of angina, stroke, being on dialysis, and alcohol use; the proportion of male patients was also comparable. The African American to white adjusted odds ratio for 18-month mortality (all cause) was 1.03 (0.66–1.59). For men versus women (30% vs 70%), the above-mentioned comorbidities were comparable, except women were more likely to have a do not resuscitate status (16% vs 7.3%; p =.000) and to be older (79.5 ± 8 vs 77 ± 7; p =.000). Men were more likely to have a history of tobacco use (30% vs 14%; p =.000) and alcohol use (36% vs 15%; p =.000), and a higher serum creatinine level (1.7 ± 1.2 vs 1.4 ± 1.1; p =.001). The men to women adjusted odds ratio for 18-month mortality (all cause) was 1.06 (0.76–1.46).

Conclusion. In this cohort of elderly patients admitted with diastolic heart failure, there were no ethnic or gender differences in 18-month mortality rates.

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				S. A. Ibrahim Author's Response to Letter to the Editor: SEX AND RACE-RELATED DIFFERENCES IN ELDERLY HEART FAILURE PATIENTS WITH PRESERVED LEFT VENTRICULAR SYSTOLIC FUNCTION J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2003; 58(7): M672 - 672. [Full Text] [PDF]