Anemia, chronic heart failure, and the impact of male vs. female gender.

Anemia is common in subjects with chronic heart failure, and correction of anemia improves quality of life and exercise capacity in both men and women. The definition of anemia is sex-specific, but enrollment criteria of studies examining the effects of recombinant human erythropoietin in chronic heart failure to date have not taken sex into account. Indeed, it is unknown whether sex-specific differences of hemoglobin values observed in normal individuals are maintained in subjects with chronic disease and volume overload states. Given the significant treatment implications for sex-specific differences in hemoglobin values, the authors analyzed data for 260 subjects consecutively admitted with decompensated chronic heart failure. In a multivariate regression analysis controlling for serum creatinine and age, female sex was independently associated with lower hemoglobin. When deciding upon initiation of treatment in this population, sex-specific targets should be applied.