Gender differences in in-hospital management and outcomes in patients with decompensated heart failure: analysis from the Acute Decompensated Heart Failure National Registry (ADHERE)

J Card Fail. 2006 Mar;12(2):100-7. doi: 10.1016/j.cardfail.2005.09.005.


Background: The impact of gender differences has not been well described in patients hospitalized with acute decompensated heart failure (ADHF).

Methods and results: Through review of medical records, data on characteristics, treatments, and outcomes were analyzed on 105,388 patient records according to gender. Women accounted for 52% of these admissions and were older than men (74.5 versus 70.1 years,) and more commonly had preserved left ventricular function (51% versus 28%). Based on history, women were less likely to have coronary artery disease (51% versus 64%) and its risk factors, but more commonly had hypertension (76% versus 70%). Both genders received similar intravenous diuretic regimens, but fewer women received vasoactive therapy (24% vs 31%). Evidence-based oral therapies were underused in both genders. Women consistently received less procedure-oriented therapy. Mean length of stay (women 5.9, men 5.8 days) and the risk-adjusted in-hospital mortality (adjusted odds ratio 0.974 [0.910-1.042], P = .4390) were similar in both genders.

Conclusion: More women than men are hospitalized with ADHF. Heart failure with preserved left ventricular function predominates in women. Though women are treated less aggressively, treatment gaps exists in both sexes. Despite these differences, length of stay and in-hospital mortality rates are similar.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anemia
  • Cardiac Catheterization / statistics & numerical data
  • Cardiac Surgical Procedures / statistics & numerical data
  • Cardiotonic Agents / therapeutic use
  • Creatinine / analysis
  • Diuretics / therapeutic use
  • Drug Utilization / statistics & numerical data
  • Female
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / epidemiology
  • Male
  • Outcome and Process Assessment, Health Care*
  • Registries
  • Sex Factors*
  • Stroke Volume / physiology
  • United States / epidemiology
  • Ventricular Dysfunction, Left / epidemiology
  • Ventricular Dysfunction, Left / physiopathology


  • Cardiotonic Agents
  • Diuretics
  • Creatinine