Women and Heart failure: Initial Data from the Canadian Clinics Network

Abstract:

Since July 1998, the Canadian CHF (chronic heart failure)
Clinics Network has been established in 11 initial centers across
Canada with the goals of improving current management,
documenting treatment patterns in different across Canada,
implementing new proven therapies and collaborating in research
to optimized patient management. Educational material for
referring physicians, nurses and patients, and a national
computerized database has developed.
Of 676 patients entered into he database in the first 9 months,
only 26% were female: age 64 yrs, LVEF 24%, 6% LVEF >45%, NYHA
class I 8%; II 31%; III 44%; IV 17%; Ischemic 48%, Idiopathic
22%, History of hypertension 31%, dyslipidemia 20%, diabetes 23,
valvular disease 13%, current smoker 7%, morbid obesity 8%,
depression 10%, ETOH abuse 2%.
Drug treatment was similar between men and women: ACE-I 77%,
B-blockers 55%, AT1, blockers 9%, Furosemide 81%, Spironolactone
13%, Digoxin 57%, antiplatelets 35%, Warfarin 29%, amiodarone
15%, hypolipemics 27%, hypoglycemics 25%. Changes in patient
management after consultation at the clinic are as follows:
medication change 47%, blood work 60%, Ekg 40%, CXR 5%, Echo 5%;
education regarding disease 40%, medication 42%,
fluid/salt/weight 43%, exercise 31%.
The Canadian CHF network allows accurate documentation of CHF in
women referred to specialized centers and will be an important
tool to monitor disease trends and treatment interventions. While
women receive similar treatments in this clinic setting, these
preliminary data suggest that more women than men may be treated
in the community without referral.