Halm M A, Penque S
John Nasseff Heart Hospital, St. Paul, MN 55102, USA.
Prog Cardiovasc Nurs. 2000 Fall;15(4):121-33. doi: 10.1111/j.0889-7204.2000.080399.x.
Heart failure affects more than 5 million Americans. Each year, about 400,000 individuals develop heart failure, making it the nation's most rapidly growing cardiac problem. Almost one third of these individuals have New York Heart Association Functional Class III or IV heart failure and are faced with progressive clinical deterioration and frequent hospital admissions. These figures will continue to escalate as the population ages. The success of interventional procedures and pharmacologic therapies in the management of coronary artery disease has enabled this population to survive acute events, at the same time creating a population with chronic disease. Common etiologies of heart failure in women include coronary artery disease, myocardial infarction, and valvular disease. However, women are at especially high risk for developing heart failure due to diastolic dysfunction associated with hypertension and diabetes. Heart failure in women is best managed across the care continuum, incorporating pharmacologic agents, interventional procedures when appropriate, dietary restrictions, self-monitoring, and psychosocial support. Much of the recent literature has focused on women and heart disease. This emphasis is partly due to public misconception about women's health problems and the growing body of research distinguishing gender differences. Significant advances in therapy have been made to improve the quality and span of life for people with heart disease. Despite therapeutic advances, however, women have high mortality rates from heart disease, including heart failure due to ischemic causes. In fact, women with heart failure present differently than men and have different etiologies and treatment options. As we learn more about women and heart disease, the distinguishing differences unfold and become helpful in establishing a plan of care.
心力衰竭影响着超过500万美国人。每年，约有40万人患上心力衰竭，使其成为美国增长最为迅速的心脏问题。这些患者中近三分之一患有纽约心脏协会心功能分级III级或IV级心力衰竭，面临着病情逐渐恶化和频繁住院的情况。随着人口老龄化，这些数字还将继续攀升。冠状动脉疾病管理中干预措施和药物治疗的成功，使这部分人群能够在急性事件中存活下来，同时造就了一批患有慢性病的人群。女性心力衰竭的常见病因包括冠状动脉疾病、心肌梗死和瓣膜疾病。然而，由于与高血压和糖尿病相关的舒张功能障碍，女性患心力衰竭的风险尤其高。女性心力衰竭的最佳管理应贯穿整个护理过程，包括使用药物、在适当的时候采取干预措施、饮食限制、自我监测以及心理社会支持。最近的许多文献都聚焦于女性与心脏病。这种关注部分是由于公众对女性健康问题的误解，以及越来越多区分性别差异的研究。在治疗方面已经取得了重大进展，以改善心脏病患者的生活质量和寿命。然而，尽管治疗取得了进展，女性心脏病死亡率仍然很高，包括缺血性原因导致的心力衰竭。事实上，女性心力衰竭患者的表现与男性不同，病因和治疗选择也不同。随着我们对女性与心脏病了解得越来越多，这些显著差异逐渐显现出来，有助于制定护理计划。
