Clinical Research in Cardiology

, Volume 104, Issue 6, pp 481–490 | Cite as

Gender differences in clinical characteristics and outcome of acute heart failure in sub-Saharan Africa: results of the THESUS-HF study

  • Okechukwu S. OgahEmail author
  • Beth A. Davison
  • Karen Sliwa
  • Bongani M. Mayosi
  • Albertino Damasceno
  • Mahmoud U. Sani
  • Charles Mondo
  • Anastase Dzudie
  • Dike B. Ojji
  • Charles Kouam
  • Ahmed Suliman
  • Neshaad Schrueder
  • Gerald Yonga
  • Sergine Abdou Ba
  • Fikru Maru
  • Bekele Alemayehu
  • Christopher Edwards
  • Gad Cotter
Original Paper



The impact of gender on the clinical characteristics, risk factors, co-morbidities, etiology, treatment and outcome of acute heart failure in sub-Saharan Africa has not been described before. The aim of this study was to evaluate the sex diffe rences in acute heart failure in sub-Saharan Africa using the data from The sub-Saharan Africa Survey of Heart Failure (THESUS-HF).

Methods and results

1,006 subjects were recruited into this prospective multicenter, international observational heart failure survey. The mean age of total population was 52.4 years (54.0 years for men and 50.7 years for women). The men were significantly older (p = 0.0045). Men also presented in poorer NYHA functional class (III and IV), p = 0.0364). Cigarette smoking and high blood pressure were significantly commoner in men (17.3 vs. 2.6 % and 60.0 vs. 51.0 % respectively). On the other hand, atrial fibrillation and valvular heart disease were significantly more frequent in women. The mean hemoglobin concentration was lower in women compared to men (11.7 vs. 12.6 g/dl, p ≤ 0.0001), while the blood urea and creatinine levels were higher in men (p < 0.0001). LV systolic dysfunctional was also seen more in men. Men also had higher E/A ratio indicating higher LV filling pressure. Outcomes were similar in both sexes.


Although the outcome of patients admitted for AHF in sub-Saharan regions is similar in men and women, some gender differences are apparent suggesting that in men more emphasis should be put on modifiable life risk factors, while in women prevention of rheumatic heart diseases and improved nutrition should be addressed vigorously.


Gender Sex Heart failure Africa 



We want to thank all the health workers who contributed in no small way to the success of this work.

Conflict of interest


Supplementary material

392_2015_810_MOESM1_ESM.doc (106 kb)
Supplementary material 1 (DOC 106 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Okechukwu S. Ogah
    • 1
    • 2
    Email author
  • Beth A. Davison
    • 3
  • Karen Sliwa
    • 2
    • 4
  • Bongani M. Mayosi
    • 5
  • Albertino Damasceno
    • 6
  • Mahmoud U. Sani
    • 7
  • Charles Mondo
    • 8
  • Anastase Dzudie
    • 9
  • Dike B. Ojji
    • 10
  • Charles Kouam
    • 9
  • Ahmed Suliman
    • 11
  • Neshaad Schrueder
    • 5
  • Gerald Yonga
    • 12
  • Sergine Abdou Ba
    • 13
  • Fikru Maru
    • 13
  • Bekele Alemayehu
    • 14
  • Christopher Edwards
    • 3
  • Gad Cotter
    • 3
  1. 1.Division of Cardiovascular Medicine, Department of MedicineUniversity College HospitalIbadanNigeria
  2. 2.Soweto Cardiovascular Research UnitUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.Momentum Research, IncDurhamUSA
  4. 4.Department of Medicine, Faculty of Health Sciences, Hatter Institute for Cardiovascular Research in Africa and the Institute of Infectious Disease and Molecular MedicineUniversity of Cape TownCape TownSouth Africa
  5. 5.Department of Medicine, Faculty of Medicine, GF Jooste and Groote Schuur HospitalsUniversity of Cape TownCape TownSouth Africa
  6. 6.Division of Cardiology, Department of MedicineEduardo Mondlane UniversityMaputoMozambique
  7. 7.Department of MedicineBayero University Kano/Aminu Kano Teaching HospitalKanoNigeria
  8. 8.Uganda Heart InstituteKampalaUganda
  9. 9.Department of Internal Medicine, Buea Faculty of Health Sciences, Cardiology UnitDouala General HospitalDoualaCameroon
  10. 10.Department of MedicineUniversity of Abuja Teaching HospitalAbujaNigeria
  11. 11.Faculty of MedicineUniversity of KhartoumKhartoumSudan
  12. 12.Department of MedicineAga Khan UniversityNairobiKenya
  13. 13.Service de Cardiologie, Faculte de medecine de DakarIbadanNigeria
  14. 14.Addis Cardiac HospitalAddis AbabaEthiopia

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