Highlights
- •Important sex-based differences exist in heart failure, including risk factors, pathophysiology, and response to therapy, yet significant gaps in knowledge remain.
- •Traditional risk factors such as hypertension, diabetes mellitus, tobacco, and obesity predispose women to heart failure to a greater extent than men.
- •Sex-based risk factors unique to women include breast cancer-related therapy, stress-induced cardiomyopathy, autoimmune disease, and pregnancy.
- •Women present with the heart failure syndrome with more severe symptoms and on the backdrop of a higher left ventricular ejection fraction.
- •Guideline-directed medical therapy, device-based therapies, and advanced therapies are underused in women.
- •Calls to action include the broader inclusion of women in clinical and basic science studies, editorial boards, clinical trial leadership, and grant funding agencies to promote sex-specific research and care.
Abstract
Heart failure (HF) continues to be a major contributor of morbidity and mortality
for men and women alike, yet how the predisposition for, course and management of
HF differ between men and women remains underexplored. Sex differences in traditional
risk factors as well as sex-specific risk factors influence the prevalence and manifestation
of HF in unique ways. The pathophysiology of HF differs between men and women and
may explain sex-specific differences in clinical presentation and diagnosis. This
in turn, contributes to variation in response to both pharmacologic and device/surgical
therapy. This review examines sex-specific differences in HF spanning prevalence,
risk factors, pathophysiology, presentation, and therapies with a specific focus on
highlighting gaps in knowledge with calls to action for future research efforts.
Key Words
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Article Info
Publication History
Published online: November 09, 2021
Accepted:
October 29,
2021
Received in revised form:
October 29,
2021
Received:
October 19,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Published by Elsevier Inc.
