Gender Differences in Predictors of Heart Failure Morbidity and Mortality in an Urban Swedish Population: The Malmo Preventive Project

Objective/Background: Reports on heart failure (HF) predictors are scarce. We assessed gender-specific HF predictors. Design: Preventive case-finding programme, register study. Setting: City population-based sample. Methods: We examined 33,342 HF-free subjects, 32.7% women, included in Malmo Preventive Project. Mean inclusion age was 49.7±7.4 years for women and 43.7±6.6 years for men. Results: During 21.7±4.3 years of average follow-up, 764 (2.3%) subjects were diagnosed with HF, 120 (1.1%) women and 644 (2.9%) men. Following bootstrap analysis, the only strong independent predictor of HF among women was smoking. Independent predictors of HF among men were diastolic blood pressure (BP), fasting blood-glucose, smoking, family history of myocardial infarction, and previous cardiovascular disease (CVD). During follow-up, 5,370 (16.1%) subjects died, 978 (9.0%) women and 4,392 (19.6%) men. Among both women and men, strong independent predictors of combined HF or all-cause death were high serum-triglycerides, fasting blood-glucose and estimated glomerular filtration rate, smoking, and previous CVD. Among men, also underweight, high BMI, and systolic and diastolic BP, were strong independent predictors of HF or death. Conclusions: Although women and men shared many predictors of HF, there were several important differences between sexes.