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Published on: August 13, 2019

Heart Disease in Older Women: Unique Challenges in Diagnosis and Management

Radmila Lybarova1, Sarah Malik2, Roopa Rao3

  • 1Department of Medicine/Cardiology, Albany Medical College, 43 New Scotland Ave, Albany, NY, US 12208, USA. lyubarr@amc.edu.

Current Cardiology Reports
|May 8, 2026
PubMed

Insights

Older women face unique cardiovascular disease challenges, including heart failure with preserved ejection fraction (HFpEF) and coronary microvascular dysfunction. Addressing these requires tailored care and increased clinical trial representation.

Area of Science:

  • Cardiology
  • Geriatrics
  • Women's Health

Background:

  • Cardiovascular disease (CVD) presents differently in older women due to aging and hormonal changes.
  • Unique pathophysiological mechanisms and clinical manifestations are observed in this demographic.

Purpose of the Study:

  • To review age- and sex-specific CVD patterns in older women.
  • To clarify the influence of aging and hormonal transitions on CVD presentation and outcomes.
  • To identify disparities and gaps in cardiovascular care for older women.

Main Methods:

  • This is a review article.
  • It synthesizes emerging data and contemporary studies.
  • Focuses on pathophysiology, diagnostic challenges, and management disparities.

Main Results:

  • Older women are disproportionately affected by heart failure with preserved ejection fraction (HFpEF), coronary microvascular dysfunction, atrial fibrillation, and valvular heart disease.
  • Atypical symptoms contribute to diagnostic delays; gaps exist in timely diagnosis, advanced therapy referral, and clinical trial representation.
  • Frailty, multimorbidity, and patient-centered care are increasingly recognized.

Conclusions:

  • Recognizing age- and sex-specific CVD characteristics is crucial.
  • Increasing representation in clinical trials and equitable access to care are vital.
  • Aligning treatment with patient priorities will improve outcomes for older women with CVD.
Abstract

Keywords:
AgingCardiovascularHealth disparitiesHeart diseaseSex-specific differences

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