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2011 | OriginalPaper | Hoofdstuk

4. Genderverschillen bij Hartfalen

Auteurs: Dr. Angela Maas, Dr. Arif Elvan, Dr. Frans Rutten

Gepubliceerd in: Handboek gynaecardiologie

Uitgeverij: Bohn Stafleu van Loghum

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Abstract

Jaarlijks overlijden in Nederland meer vrouwen dan mannen aan hartfalen (zie figuur 2.2). De prevalentie van hartfalen wordt geschat op 1-3% in de Europese populatie en het percentage neemt sterk toe na het 65e jaar. Bij 70-80-jarigen wordt de prevalentie geschat op 10-20%.1,2 Ongeveer de helft van alle patiënten met hartfalen zijn vrouwen en gezien hun langere levensverwachting dan mannen is het aannemelijk dat het aantal oudere vrouwen met hartfalen verder zal toenemen. Vrouwen hebben overwegend hartfalen op basis van een diastolische disfunctie (met behouden ejectiefractie), terwijl mannen vaker hartfalen hebben door een systolische disfunctie (met verlaagde ejectiefractie). De sterfte aan hartfalen is de afgelopen twintig jaar vooral gedaald bij mannen, maar niet bij vrouwen.3 Dit heeft niet alleen te maken met belangrijke sekseverschillen in de etiologie van hartfalen, maar ook met onderdiagnostiek en onderbehandeling van vrouwen.4,5 In de belangrijkste gerandomiseerde studies naar geneesmiddelen bij hartfalen van de afgelopen twee decennia waren zij sterk ondervertegenwoordigd: gemiddeld maakten zij slechts 25% van de onderzoekspopulaties uit. Dit is belangrijk omdat er naast de verschillen in etiologie en pathofysiologie ook genderverschillen zijn in reactie en bijwerkingen van medicatie.6 In de meest recente richtlijnen voor de behandeling van hartfalen van de European Society of Cardiology worden deze verschillen echter niet of nauwelijks genoemd.2
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Metagegevens
Titel
Genderverschillen bij Hartfalen
Auteurs
Dr. Angela Maas
Dr. Arif Elvan
Dr. Frans Rutten
Copyright
2011
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-313-8782-3_4