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Updated: Oct 1, 2025
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Sex Differences in Therapies for Heart Failure
Davor Miličić1, Maria Bergami2, Saša Pavasović1
1Department of Cardiovascular Diseases, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb, Croatia.
Current Pharmaceutical Design
|March 2, 2022
Summary
Gender disparities exist in heart failure (HF) treatment. While current guidelines are appropriate, women may benefit from angiotensin receptor blockers (ARBs) as first-line therapy and require stricter digoxin monitoring.
Area of Science:
- Cardiology
- Pharmacology
- Gender Medicine
Background:
- Heart failure (HF) presents distinct etiopathogenesis and prognosis in men and women.
- Understanding gender-based differences in HF pharmacological therapy is crucial for optimizing patient outcomes.
Purpose of the Study:
- To review gender-based differences in response to pharmacological therapies for heart failure (HF) with or without reduced ejection fraction (EF).
- To evaluate outcomes of HF therapies including ACE inhibitors (ACEi), ARBs, ARNI, beta-blockers, MRAs, diuretics, ivabradine, and digoxin, stratified by gender.
Main Methods:
- Review of randomized controlled trials (RCTs) and large registries.
- Analysis of gender-specific data on the efficacy and safety of various HF medications.
Main Results:
- Current HF guidelines recommending similar therapeutic approaches for men and women are generally appropriate.
- Angiotensin receptor blockers (ARBs) may be considered a first-line therapy for women instead of ACE inhibitors.
- Female patients require stricter digoxin monitoring due to higher sensitivity and increased risk of complications.
Conclusions:
- While current guidelines are largely appropriate, individualized therapeutic strategies considering gender are warranted.
- Future clinical trials must address the underrepresentation of women to enable robust subgroup analyses and personalized preventative strategies.
Keywords:
HFpEFHeart failureangiotensin receptor blockersangiotensin-converting enzyme inhibitorsdigoxinrandomized controlled trialsex differenceswomenMore Related Videos
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