Sex Influence on Heart Failure Prognosis

Area of Science:

• Cardiology
• Sex-based Medicine

Background:

• Heart failure (HF) affects 1-2% of developed populations, with women comprising ~50% of patients.
• Women with HF are often older and present with hypertension, valvular heart disease, and non-ischemic cardiomyopathy.
• Limited prospective HF studies on women necessitate inferences from male-centric trials and registries.

Purpose of the Study:

• To describe sex-related differences in heart failure (HF).
• To explore how these differences may explain the better prognosis observed in women with HF compared to men.

Main Methods:

• Review of existing literature and clinical trial data focusing on sex-based differences in HF.
• Analysis of patient demographics, comorbidities, clinical presentation, treatment patterns, and outcomes.

Main Results:

• Women exhibit greater clinical severity, more symptoms, and worse functional class in HF.
• Despite lower receipt of guideline-proven HF therapies, women demonstrate a survival advantage over men.
• Potential contributing factors to female survival, such as prior pregnancies, are considered.

Conclusions:

• Significant sex-related differences exist in heart failure (HF) regarding age, etiology, comorbidities, and clinical presentation.
• Women with HF have a better prognosis than men, a phenomenon not fully explained by current understanding or treatment disparities.
• Further research is needed to elucidate the biological and clinical factors, including potential roles of prior pregnancies, contributing to women's improved HF survival.