Gender differences related to the presence of atrial fibrillation in older hypertensive patients

Table 1 Baseline characteristics of the study population, including biochemical, electrocardiogram and treatment data (mean ± SD) n (%)

Characteristics	Data
WBC, mm3	6727 ± 1774
Haemoglobin, g/dL	13.6 ± 1.8
Glucose, mg/dL	108 ± 31
LDL-cholesterol, mg/dL	118 ± 34
Triglycerides, mg/dL	129 ± 73
Uric acid, mg/dL	5.2 ± 1.1
Creatinine, mg/dL	0.97 ± 0.28
Glomerular filtration rate, mL/min	75 ± 22.5
Albumin/creatinine ratio	39.4 ± 109.8
Heart rate, bpm	71.7 ± 14
Normal QRS	794 (77.2)
Q waves	25 (2.4)
Sokolow LVH	15 (1.5)
Cornell LVH	103 (10)
Strain	84 (8.2)
Global LVH	177 (17.2)
Measurement of anti-HT	1.7 ± 0.87
Diuretics	535 (52.1)
Beta-blockers	240 (23.4)
Calcium antagonists	199 (19.4)
ACEI	265 (25.8)
ARB	611 (59.5)
Antiplatelet agents	196 (19.1)
VKA	72 (7.0)
No anti-HT drugs	62 (6)
Monotherapy	366 (35.6)
2 drugs	366 (35.6)
3 or more anti-HT drugs	234 (22.7)

WBC: White blood cell; LVH: Left ventricle hypertrophy; HT: Hypertension; ACEI: Angiotensin-converting enzyme inhibitors; ARB: Angiotensin receptor blocker; VKA: Vitamin K antagonist; LDL: Low-density lipoprotein.

Table 2 Epidemiological, clinical and therapeutic differences between genders (mean ± SD) n (%)

	Females	Males	P value
	(n = 542)	(n = 486)
Mean age, yr	72.7 ± 5.8	72.8 ± 5.8	NS
Abdominal circumference, cm	96.6 ± 11.8	100.4 ± 11.0	< 0.001
Weight, kg	71.4 ± 11.5	79.5 ± 11.5	< 0.001
Mean height, cm	155.2 ± 6.7	166.7 ± 6.7	< 0.001
BMI	29.6 ± 4.5	28.6 ± 3.6	< 0.001
Obesity	224 (41.4)	160 (32.9)	0.005
Years from the onset of HT	11.0 ± 8.2	10.8 ± 8.1	NS
Diabetes mellitus	134 (24.7)	150 (30.9)	0.03
Dyslipidaemia	267 (49.3)	230 (47.3)	NS
Smokers	17 (3.1)	76 (15.6)	< 0.001
Sedentariness	352 (70.5)	274 (56.4)	< 0.001
Regular alcohol intake	5 (0.9)	33 (6.8)	< 0.001
History of stroke	32 (6.0)	32 (6.7)	NS
History of IHD	55 (10.1)	124 (25.5)	< 0.001
History of HF	35 (6.5)	39 (8.1)	NS
History of renal insufficiency	24 (4.5)	38 (7.9)	0.025
Peripheral arterial disease	15 (2.7)	37 (7.7)	0.001
Carotid disease	2 (0.4)	13 (2.8)	0.003
Atrial fibrillation	50 (9.2)	56 (11.5)	NS
CHADS ≥ 2	275 (50.7)	272 (56.0)	NS
LVH by ECG	111 (20.5)	66 (13.6)	0.004
LVH_Sokolow	6 (1.1)	9 (1.9)	NS
LVH_Cornell	91 (16.8)	12 (2.5)	< 0.001
Mean HR, bpm	75.4 (10.7)	72.1(10.7)	< 0.001
Mean number of anti-HT	1.7 ± 0.87	1.8 ± 1.0	NS
Diuretics	304 (56.1)	226 (46.5)	0.002
Beta-blockers	105 (19.4)	98 (20.2)	NS
Calcium antagonists	93 (17.2)	80 (16.5)	NS
ACEI	118 (21.8)	128 (26.3)	NS
ARB	318 (58.7)	294 (60.5)	NS
Antiplatelet agents	90 (16.6)	112 (23.0)	0.012
VKA	33 (6.1)	32 (6.6)	NS

BMI: Body mass index; IHD: Ischaemic heart disease; HF: Heart failure; LVH: Left ventricle hypertrophy; HR: Heart rate; HT: Hypertension; ACEI: Angiotensin-converting enzyme inhibitors; ARB: Angiotensin receptor blocker; VKA: Vitamin K antagonist. NS: No significant.

Table 3 Independent predictors of global atrial fibrillation in the total study population and in subgroups according to gender

Variable	Total	Females	Males
	OR (95%CI)	OR (95%CI)	OR (95%CI)
Age, yr	1.1 (1.1-1.1)	1.1 (1.1-1.1)	1.1 (1.03-1.13)
	P < 0.001	P = 0.010	P = 0.003
Alcohol abuse	5.2 (2.1-12.2)	7.0 (0.6-82.9)	4.2 (1.5-11.4)
	P = 0.001	NS	P = 0.005
Heart disease	4.7 (3.0-7.5)	6.1 (3.1-12.4),	3.4 (1.9-6.2)
	P < 0.001	P < 0.001	P < 0.01
GFR, mL/min per m2	0.98 (0.97-0.99)	0.98 (0.96-0.99)	0.99 (0.9-1.0)
	P = 0.027	P = 0.039	NS
Strain on ECG	1.8 (0.9-3.4)	2.97 (1.1-8.1)	1.2 (0.53-2.81)
	P = NS	P = 0.032	NS

Multivariate analysis: Age, gender, body mass index, physical exercise, alcohol use, time from the onset of hypertension, clinical blood pressure, 24-h ambulatory blood pressure monitoring result, family history of early cardiovascular disease, diabetes, smoking, obesity, dyslipidaemia, abdominal obesity, left ventricular hypertrophy, atherosclerotic plaque, renal damage, coronary disease, heart failure, renal disease, and treatment type. GFR: Glomerular filtration rate; ECG: Electrocardiogram; NS: No significant.

Table 4 Treatment differences between genders in patients with atrial fibrillation (n = 106) n (%)

	Females	Males	P value
	(n = 50)	(n = 56)
Diuretics	34 (68.0)	30 (53.6)	NS
Beta-blockers	16 (32)	17 (30.4)	NS
Calcium antagonists	15 (30)	5 (8.9)	0.007
ACEI	12 (24)	14 (25)	NS
ARB	32 (64)	31 (55.4)	NS
Antiplatelet agents	4 (8)	16 (26.8)	0.010
VKA	29 (58)	25 (44.6)	NS
ATG or VKA	33 (66)	41 (71.4)	NS

ACEI: Angiotensin-converting enzyme inhibitors; ARB: Angiotensin receptor blocker; VKA: Vitamin K antagonist; ATG: Anti-aggregants. NS: No significant.