What is the prognosis for someone with heart failure?
Heart failure remains one of the most serious types of heart disease. The outlook for a woman with heart failure depends on her age, overall health, the severity of the condition, and how well she follows and responds to treatment.
Over the past 50 years, the overall chance of a woman dying of heart failure has dropped.27 The earlier the stage when your heart failure is diagnosed, the better your chance of surviving. Women in stage A of the AHA/ACC heart failure staging system can be treated to prevent or slow the progression of heart failure to a more advanced stage. A study of 2029 patients (52% were women) found that the heart failure stages were associated with worsening 5-year survival rates: from 97% in stage A and 96% in stage B to 75% in stage C and 20% in stage D.28
Survival is better for women with milder symptoms of heart failure. The milder your heart failure symptoms are, the more they can be eased with treatment and the better your prognosis will be. Women with NYHA class 1 heart failure symptoms do better than women with the more severe class 4 symptoms.29, 30 A study of 3726 patients (25% were women) found that 66% of patients with NYHA classes 1 and 2 symptoms survived for at least 3 years, compared with 58% of patients with NYHA classes 3 and 4 symptoms.29
Women with heart failure survive longer than men, perhaps because women tend to live longer than men.2, 10, 27, 31, 32 Some researchers think it is related to the cause of the heart failure. Women tend to have heart failure mostly due to high blood pressure,30 which develops gradually over a long period of time. Men are more likely to have heart failure as a result of coronary artery disease or heart attack, which can damage the heart muscle more severely and more quickly by depriving it of oxygen. When women develop heart failure caused by a heart attack or coronary artery disease, they do worse than women with heart failure due to other causes.32, 33 Other researchers argue that women with heart failure have a better survival rate than men regardless of what caused the heart failure.2
The prognosis for someone with heart failure varies from person to person and is based on individual factors, such as the cause and severity of heart failure. There is much that you and your doctor can do to improve the quality of your life and your chances of survival, such as risk factor management, lifestyle modifications, and various forms of treatment.
- Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. Sep 20 2005;46(6):e1-82.
- O'Meara E, Clayton T, McEntegart MB, et al. Sex Differences in Clinical Characteristics and Prognosis in a Broad Spectrum of Patients With Heart Failure: Results of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) Program. Circulation. June 19, 2007;115(24):3111-3120.
- Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. Jan 29 2008;117(4):e25-146.
- Lloyd-Jones DM, Larson MG, Leip EP, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. Dec 10 2002;106(24):3068-3072.
- Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. May 22-29 1996;275(20):1557-1562.
- Philbin EF, DiSalvo TG. Influence of race and gender on care process, resource use, and hospital-based outcomes in congestive heart failure. Am J Cardiol. Jul 1 1998;82(1):76-81.
- Ghali JK, Pina IL, Gottlieb SS, Deedwania PC, Wikstrand JC. Metoprolol CR/XL in female patients with heart failure: analysis of the experience in Metoprolol Extended-Release Randomized Intervention Trial in Heart Failure (MERIT-HF). Circulation. Apr 2 2002;105(13):1585-1591.
- Schocken DD, Benjamin EJ, Fonarow GC, et al. Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation. May 13, 2008;117(19):2544-2565.
- Kenchaiah S, Evans JC, Levy D, et al. Obesity and the Risk of Heart Failure. N Engl J Med. August 1, 2002;347(5):305-313.
- Lund LH, Mancini D. Heart failure in women. Med Clin North Am. Sep 2004;88(5):1321-1345, xii.
- Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26- year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968-977.
- Maron BJ, Towbin JA, Thiene G, et al. Contemporary Definitions and Classification of the Cardiomyopathies: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. April 11, 2006;113(14):1807-1816.
- Ardehali H, Kasper E, Baughman K. Peripartum cardiomyopathy. Minerva Cardioangiol. 2003;51:41-48.
- Schocken DD, Arrieta MI, Leaverton PE, Ross EA. Prevalence and mortality rate of congestive heart failure in the United States. J Am Coll Cardiol. Aug 1992;20(2):301-306.
- Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol. Oct 1993;22(4 Suppl A):6A-13A.
- Mezu U, Bott-Silverman C, Hsich E. Heart failure in women is different than in men; should treatment be different? Cleve Clin J Med. Jun 2007;74(6):423-424, 426, 429-435.
- Yancy C. Heart Failure in African Americans. Am J Cardiol. 2005;96(7):3-12.
- Bourassa MG, Gurne O, Bangdiwala SI, et al. Natural history and patterns of current practice in heart failure. The Studies of Left Ventricular Dysfunction (SOLVD) Investigators. J Am Coll Cardiol. Oct 1993;22(4 Suppl A):14A-19A.
- Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol. Jul 1974;34(1):29-34.
- Stromberg A, Martensson J. Gender differences in patients with heart failure. Eur J Cardiovasc Nurs. Apr 2003;2(1):7-18.
- Tandon S, Hankins SR, Le Jemtel TH. Clinical Profile of Chronic Heart Failure in Elderly Women. Am J Geriatr Cardiol. 2002;11(5):318-325.
- Halm MA, Penque S. Heart failure in women. Prog Cardiovasc Nurs. Fall 2000;15(4):121-133.
- Bursi F, Weston SA, Redfield MM, et al. Systolic and Diastolic Heart Failure in the Community. JAMA. November 8, 2006;296(18):2209-2216.
- Zile MR. Heart failure with preserved ejection fraction: is this diastolic heart failure? J Am Coll Cardiol. May 7, 2003;41(9):1519-1522.
- Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of Systolic and Diastolic Ventricular Dysfunction in the Community: Appreciating the Scope of the Heart Failure Epidemic. JAMA. January 8, 2003;289(2):194-202.
- Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. May 21, 2003;289(19):2560-2571.
- Levy D, Kenchaiah S, Larson MG, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. Oct 31 2002;347(18):1397-1402.
- Ammar KA, Jacobsen SJ, Mahoney DW, et al. Prevalence and Prognostic Significance of Heart Failure Stages: Application of the American College of Cardiology/American Heart Association Heart Failure Staging Criteria in the Community. Circulation. March 27, 2007;115(12):1563-1570.
- Ahmed A. A Propensity Matched Study of New York Heart Association Class and Natural History End Points in Heart Failure. Am J Cardiol. 2007;99(4):549-553.
- Frazier CG, Alexander KP, Newby LK, et al. Associations of Gender and Etiology With Outcomes in Heart Failure With Systolic Dysfunction: A Pooled Analysis of 5 Randomized Control Trials. J Am Coll Cardiol. April 3, 2007;49(13):1450-1458.
- Roger VL, Weston SA, Redfield MM, et al. Trends in heart failure incidence and survival in a community-based population. JAMA. Jul 21 2004;292(3):344-350.
- Adams KF, Jr., Sueta CA, Gheorghiade M, et al. Gender Differences in Survival in Advanced Heart Failure : Insights From the FIRST Study. Circulation. April 13, 1999;99(14):1816-1821.
- Ghali JK, Krause-Steinrauf HJ, Adams KF, et al. Gender differences in advanced heart failure: insights from the BEST study. J Am Coll Cardiol. Dec 17 2003;42(12):2128-2134.