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Sex and Gender Differences in Heart Failure
Vera Regitz-Zagrosek1,2,3
1Berlin Institute for Gender in Medicine, Charité Universitätsmedizin, Berlin, Germany.
International Journal of Heart Failure
|October 20, 2022
Summary
Sex significantly impacts heart failure (HF) presentation and treatment. Women experience different HF types and respond uniquely to therapies, highlighting the need for sex-specific research and care.
Area of Science:
- Cardiology
- Sex-based Medicine
- Translational Research
Background:
- Heart failure (HF) exhibits distinct sex-based phenotypes, with preserved ejection fraction (EF) more common in women and reduced EF (HFrEF) in men.
- Women with HF generally have better survival rates and lower risks of sudden death compared to men.
- Etiologies differ, with ischemia prevalent in men, while hypertension and diabetes are more significant contributors in women.
Purpose of the Study:
- To explore the sex-specific differences in heart failure pathophysiology, clinical presentation, and therapeutic responses.
- To emphasize the need for sex-disaggregated data in clinical trials and research.
- To highlight unique HF conditions in women, such as Takotsubo and peripartum cardiomyopathy.
Main Methods:
- Review of existing literature on sex differences in heart failure.
- Analysis of epidemiological data regarding HF prevalence and outcomes by sex.
- Examination of pharmacological responses to HF therapies based on sex.
Main Results:
- Women exhibit greater left ventricular stiffness and higher EF, potentially due to age-related fibrosis and hormonal influences.
- Estrogen's differential effect on collagen production in male and female cardiac fibroblasts noted.
- Metabolic profiles and responses to therapies like sacubitril-valsartan show significant sex-based variations.
Conclusions:
- Sex is a critical determinant in heart failure, influencing disease mechanisms, progression, and treatment efficacy.
- Current research and clinical trials inadequately report sex-specific outcomes, hindering personalized medicine.
- Further investigation into sex differences is essential for advancing heart failure management and improving patient outcomes.
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