Sex-related differences in chronic heart failure

Area of Science:

• Cardiology
• Sex Differences in Medicine

Background:

• Chronic heart failure (CHF) prevalence is rising globally.
• Significant sex-based differences exist in CHF etiology, presentation, prognosis, and comorbidities.
• Women with CHF often present later in life with preserved ejection fraction and different comorbidities like hypertension and diabetes.

Purpose of the Study:

• To review and highlight the sex-related differences in chronic heart failure.
• To emphasize the impact of these differences on clinical presentation, prognosis, and treatment response.
• To underscore the need for better characterization of sex differences for personalized CHF therapy.

Main Methods:

• Review of existing literature on sex differences in chronic heart failure.
• Analysis of epidemiological data, clinical presentations, and treatment outcomes stratified by sex.
• Examination of sex-specific responses to various therapeutic interventions.

Main Results:

• Women develop CHF at older ages, more frequently with HFpEF, and report worse quality of life but have a better prognosis.
• Non-ischemic etiology and comorbidities like hypertension and diabetes are more common in women.
• Sex-specific treatment responses include greater benefits from ARBs in women, higher complication rates with defibrillators, and differential responses to CRT.

Conclusions:

• Significant sex-based differences in CHF necessitate tailored therapeutic strategies.
• Women are underrepresented in clinical trials, hindering a full understanding of sex-specific aspects of CHF.
• Further research characterizing these differences is essential for advancing personalized medicine in chronic heart failure care.