Predictors of quality of life in women with heart failure

Background: Two and one half million women have heart failure (HF). Yet lit tle is known about quality of life (QOL) in this population and the factors influencing it. Given the importance of QOL as an outcome of care, we cond ucted a study to evaluate predictors of QOL in women with HF. Methods: Using baseline QOL data collected in the Studies of Left Ventricul ar Dysfunction (SOLVD) trials, we studied predictors of QOL in 691 women wi th HF. Univariate, bivariate, and multiple regression analyses;were used. P otential predictors included age, education, tobacco use, social isolation, life stresses, comorbidity index, New York Heart Association (NYHA) class, HF symptoms, etiology, and medications. We measured global QOL and QOL dim ensions of physical function, emotional distress, and social and general he alth. Results: Women were older (61 +/- 10.5 years), predominately Caucasian (75% ), and their mean ejection fraction was 0.27 (+/- 6.51). Variables with the strongest relationship to QOL included dyspnea, NYHA class, and life stres ses. As dyspnea, life stresses, and NYHA class increased, QOL decreased. Ad ditionally, smoking behavior and vasodilator use was associated with decrea sed QOL. Heart failure etiology of ischemic origin was associated with decr eased social life satisfaction, and use of digitalis was predictive of incr eased social life satisfaction. Finally, increasing age was related to an i ncrease in general life satisfaction. Conclusions: Symptom amelioration, which may improve functional ability, ha s the greatest potential for increasing QOL in women with HF. Programs to i ncrease physical activity in women with HF should be developed and tested. Finally, clinicians may need to optimize HF medications in women.