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Published on: July 18, 2014
Advanced heart failure and transplantation in women
1The Care Group, LLC, 8333 Naab Road, Suite 400, Indianapolis, IN 46260, USA. macwalsh@iquest.net
Insights
Nearly half of heart failure (HF) patients are women, often elderly with preserved ejection fraction. Research must include women and analyze sex-specific outcomes for better HF treatment.
Area of Science:
- Cardiology
- Women's Health
- Clinical Trials
Background:
- Heart failure (HF) affects nearly 5 million Americans, with women comprising about half of this population.
- Women with advanced HF are frequently elderly and may present with HF with preserved ejection fraction (HFpEF).
- Hypertension and diabetes are significant risk factors for HF in women, alongside coronary artery disease.
Purpose of the Study:
- To highlight the underrepresentation of women in HF clinical trials.
- To emphasize the need for sex-specific analysis of HF therapies.
- To underscore the importance of considering sex-based differences in HF outcomes and treatment strategies.
Main Methods:
- Review of existing literature on heart failure prevalence and risk factors in women.
- Analysis of clinical trial enrollment data regarding sex distribution.
- Examination of reported sex-specific outcomes from HF therapy trials.
Main Results:
- Women constitute approximately 50% of the HF population, often being older and having HFpEF.
- Fewer women than men are enrolled in HF clinical trials.
- While some sex-specific results exist, comprehensive analysis of all trial data by sex is lacking.
Conclusions:
- Cardiac transplantation remains a viable option for women with advanced HF.
- Future HF research must prioritize the enrollment of women.
- All HF trial data analysis should be stratified by sex to ensure equitable and effective treatment.
Abstract:
Approximately half of the nearly 5 million people in the United States who have heart failure (HF) are women. The vast majority of women with advanced HF are elderly and many of them have HF with evidence of normal or preserved left ventricular systolic function. Although coronary disease is a common cause of HF for both men and women, a history of hypertension or diabetes places a woman at particular risk. Many fewer women than men have been enrolled in trials of therapies for patients with HF. Sex-specific results have been reported for some of these therapies, but not all trial data have been analyzed for sex-related differences. In spite of these differences in outcome, cardiac transplantation remains an important option for women with very advanced HF. Future research on therapies for HF will need to target women for enrollment, and all data analysis should include results that are stratified by sex.
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