Sex Differences in Heart Failure With Preserved Ejection Fraction (HFpEF): A Narrative Review

Area of Science:

• Cardiology
• Clinical Medicine
• Sex Differences Research

Background:

• Heart failure with preserved ejection fraction (HFpEF) is the most common type of heart failure, especially in older adults.
• HFpEF presents clinical heterogeneity and limited treatment options, posing management challenges.
• Sex-related differences in HFpEF are critical but underappreciated, impacting prognosis and treatment.

Purpose of the Study:

• To highlight the significance of sex-specific differences in heart failure with preserved ejection fraction (HFpEF).
• To underscore the need for tailored treatment strategies addressing the unique needs of women and men with HFpEF.

Main Methods:

• Review of large clinical trials and post hoc analyses in HFpEF.
• Analysis of sex-specific outcomes, treatment responses, and quality of life data.
• Examination of women's underrepresentation in HFpEF research.

Main Results:

• Women are disproportionately affected by HFpEF, often with higher comorbidity and hospitalization rates but better long-term survival.
• Women may experience greater benefits from certain HFpEF therapies, including reduced mortality and hospitalizations.
• Existing trials are often underpowered to detect sex-specific treatment effects, and women are underrepresented in studies.

Conclusions:

• Recognizing and understanding sex-specific differences in HFpEF is essential for clinical practice.
• Tailored and equitable treatment strategies are crucial for managing HFpEF in both women and men.
• Further research with adequate power to detect sex-specific effects is needed.