Document Type

Article

Department

Internal Medicine (East Africa); Brain and Mind Institute

Abstract

Background Cardiovascular disease is the leading cause of death globally, with approximately 80% of these deaths occurring in low- and middle-income countries. Sex differences in cardiovascular disease are well described in high-income countries but limited in low- and middle-income countries.

Objectives This study sought to evaluate the sex differences in clinical presentation, cardiovascular risk profile, diagnosis, treatment, and outcomes among patients in the Kenya Heart Registry.

Methods Data were prospectively collected from 3 tertiary hospitals, including patients with heart failure, acute coronary syndrome, venous thromboembolism, and atrial fibrillation. Primary outcomes were in-hospital and 6-month mortality, as well as sex-specific differences in clinical presentation, cardiovascular risk factors, diagnosis, and treatment.

Results Among 1,687 participants, 51.3% were women. Of these, 1,241 were admitted, while 446 were managed as outpatients. Women were younger (50.9 vs 54.2 years; P < 0.001), had lower monthly income, higher left ventricular ejection fraction, higher rates of heart failure with preserved ejection fraction, venous thromboembolism, and atrial fibrillation, and lower rates of acute coronary syndrome than men. No sex difference was observed in diagnostics or treatment or adherence to guideline-directed therapies. In-hospital and 6-month all-cause mortality were 7.4% and 14.7%, respectively, and were similar by sex (women 8.0% and 14.8% vs men 6.9% and 14.5%; P = 0.449 and P = 0.881, respectively).

Conclusions Significant sex differences exist in clinical profiles, but management and outcomes are similar. Scaling up evidence-based interventions is urgently needed to reduce the high mortality in this population.

AKU Student

no

Publication (Name of Journal)

JACC: Advances

DOI

https://doi.org/10.1016/j.jacadv.2025.102466

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