Strömberg Anna, Mårtensson Jan
Department of Cardiology, Heart Centre, Linköping University Hospital, S-581 85 Linköping, Sweden.
Eur J Cardiovasc Nurs. 2003 Apr;2(1):7-18. doi: 10.1016/S1474-5151(03)00002-1.
The aim of this literature review was to review and discuss the differences between men and women with heart failure with regard to epidemiology, aetiology, diagnostics, prognosis, pharmacological and non-pharmacological treatment, and the impact of heart failure on psychosocial factors and healthcare utilisation.
Two primary health care resources, MEDLINE and CINAHL, were selected to review the current literature. In MEDLINE, 234 abstracts dealing with heart failure and gender/sex were found and in CINAHL, 20 abstracts.
Men have a higher incidence of heart failure, but the overall prevalence rate is similar in both sexes, since women survive longer after the onset of heart failure. Women tend to be older when diagnosed with heart failure and more often have diastolic dysfunction than men. The extent of sex differences in treatment, hospital cost and quality of care can partly be explained by age differences. The life situations for men and women with heart failure are different. Physical and social restrictions affecting daily life activities are experienced as most bothersome for men, whereas restrictions affecting the possibility to support family and friends are most difficult to accept for women. Women with heart failure ascribe more positive meanings to their illness. Despite this, women seem to experience a lower overall quality of life than men. The known gender differences in patients with heart failure need to be highlighted in guidelines as well as implemented in standard care.
本综述旨在回顾和讨论心力衰竭男性与女性在流行病学、病因、诊断、预后、药物及非药物治疗,以及心力衰竭对心理社会因素和医疗利用的影响等方面的差异。
选取两个主要的医疗保健资源数据库MEDLINE和CINAHL来检索当前文献。在MEDLINE中,检索到234篇关于心力衰竭与性别/性别的摘要,在CINAHL中检索到20篇摘要。
男性心力衰竭的发病率较高,但总体患病率在两性中相似,因为女性在心力衰竭发病后存活时间更长。女性被诊断为心力衰竭时往往年龄更大,且比男性更常出现舒张功能障碍。治疗、住院费用和护理质量方面的性别差异程度部分可由年龄差异来解释。心力衰竭男性和女性的生活状况不同。对男性来说,影响日常生活活动的身体和社会限制最令人困扰,而对女性来说,影响支持家人和朋友的可能性的限制最难接受。心力衰竭女性对自己的疾病赋予了更多积极意义。尽管如此,女性的总体生活质量似乎低于男性。心力衰竭患者中已知的性别差异需要在指南中加以强调,并在标准护理中得以落实。