Gender differences in the effects of physical and emotional symptoms on health-related quality of life in patients with heart failure

Background: Physical and emotional symptoms are common in heart failure. These symptoms are theorized to affect health-related quality of life (HRQOL), but their impact is likely mediated by variables not yet explored. Moreover, gender may affect these relationships. Aim: To determine gender differences in the effects of physical and emotional symptom status on HRQOL. Methods and results: Data from 51 men and 47 women with heart failure were analyzed using regression analyses. There were no gender differences in physical or emotional symptom status, or HRQOL, but there were differences in the dynamic relationships among the variables. In bivariate analyses, physical and emotional symptom status was related to HRQOL in both men and women. However, in women, physical symptom status was related to HRQOL, while in men depression affected HRQOL in multivariate analyses (p < .001, r² = .27; p < .001, r² = .40, respectively). Functional status measured by the New York Heart Association functional class mediated the effects of anxiety and depression on HRQOL only in women. Conclusion: There were gender differences in the dynamic relationships among variables related to HRQOL. These results demonstrate the need for individualized, comprehensive evaluation of patient's HRQOL and symptom status in order to appropriately target interventions.