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Sex Differences in Heart Failure : What Do We Know?

Arata, Allegra ; Ricci, Fabrizio LU ; Khanji, Mohammed Y. ; Mantini, Cesare ; Angeli, Francesco ; Aquilani, Roberta ; Di Baldassarre, Angela ; Renda, Giulia ; Mattioli, Anna Vittoria and Nodari, Savina , et al. (2023) In Journal of cardiovascular development and disease 10(7).
Abstract

Highlights: Women predominantly exhibit HFpEF compared to men. Factors exclusive to women, such as adverse pregnancy outcomes and premature menopause, elevate the risk of HF. The establishment of sex-specific optimal drug dosages and concrete guidelines for device therapy is essential. Concerted multidisciplinary initiatives are crucial to bridge the existing sex disparities in HF management. Heart failure (HF) remains an important global health issue, substantially contributing to morbidity and mortality. According to epidemiological studies, men and women face nearly equivalent lifetime risks for HF. However, their experiences diverge significantly when it comes to HF subtypes: men tend to develop HF with reduced ejection fraction... (More)

Highlights: Women predominantly exhibit HFpEF compared to men. Factors exclusive to women, such as adverse pregnancy outcomes and premature menopause, elevate the risk of HF. The establishment of sex-specific optimal drug dosages and concrete guidelines for device therapy is essential. Concerted multidisciplinary initiatives are crucial to bridge the existing sex disparities in HF management. Heart failure (HF) remains an important global health issue, substantially contributing to morbidity and mortality. According to epidemiological studies, men and women face nearly equivalent lifetime risks for HF. However, their experiences diverge significantly when it comes to HF subtypes: men tend to develop HF with reduced ejection fraction more frequently, whereas women are predominantly affected by HF with preserved ejection fraction. This divergence underlines the presence of numerous sex-based disparities across various facets of HF, encompassing aspects such as risk factors, clinical presentation, underlying pathophysiology, and response to therapy. Despite these apparent discrepancies, our understanding of them is far from complete, with key knowledge gaps still existing. Current guidelines from various professional societies acknowledge the existence of sex-based differences in HF management, yet they are lacking in providing explicit, actionable recommendations tailored to these differences. In this comprehensive review, we delve deeper into these sex-specific differences within the context of HF, critically examining associated definitions, risk factors, and therapeutic strategies. We provide a specific emphasis on aspects exclusive to women, such as the impact of pregnancy-induced hypertension and premature menopause, as these unique factors warrant greater attention in the broader HF discussion. Additionally, we aim to clarify ongoing controversies and knowledge gaps pertaining to the pharmacological treatment of HF and the sex-specific indications for cardiac implantable electronic devices. By shining a light on these issues, we hope to stimulate a more nuanced understanding and promote the development of more sex-responsive approaches in HF management.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gender medicine, guidelines, heart failure, menopause, pregnancy, sex, treatment
in
Journal of cardiovascular development and disease
volume
10
issue
7
article number
277
publisher
MDPI AG
external identifiers
  • pmid:37504533
  • scopus:85166423891
ISSN
2308-3425
DOI
10.3390/jcdd10070277
language
English
LU publication?
yes
id
b06667fe-2020-411f-a1a3-19ba18dc9e33
date added to LUP
2023-11-02 13:47:22
date last changed
2024-04-19 03:29:03
@article{b06667fe-2020-411f-a1a3-19ba18dc9e33,
  abstract     = {{<p>Highlights: Women predominantly exhibit HFpEF compared to men. Factors exclusive to women, such as adverse pregnancy outcomes and premature menopause, elevate the risk of HF. The establishment of sex-specific optimal drug dosages and concrete guidelines for device therapy is essential. Concerted multidisciplinary initiatives are crucial to bridge the existing sex disparities in HF management. Heart failure (HF) remains an important global health issue, substantially contributing to morbidity and mortality. According to epidemiological studies, men and women face nearly equivalent lifetime risks for HF. However, their experiences diverge significantly when it comes to HF subtypes: men tend to develop HF with reduced ejection fraction more frequently, whereas women are predominantly affected by HF with preserved ejection fraction. This divergence underlines the presence of numerous sex-based disparities across various facets of HF, encompassing aspects such as risk factors, clinical presentation, underlying pathophysiology, and response to therapy. Despite these apparent discrepancies, our understanding of them is far from complete, with key knowledge gaps still existing. Current guidelines from various professional societies acknowledge the existence of sex-based differences in HF management, yet they are lacking in providing explicit, actionable recommendations tailored to these differences. In this comprehensive review, we delve deeper into these sex-specific differences within the context of HF, critically examining associated definitions, risk factors, and therapeutic strategies. We provide a specific emphasis on aspects exclusive to women, such as the impact of pregnancy-induced hypertension and premature menopause, as these unique factors warrant greater attention in the broader HF discussion. Additionally, we aim to clarify ongoing controversies and knowledge gaps pertaining to the pharmacological treatment of HF and the sex-specific indications for cardiac implantable electronic devices. By shining a light on these issues, we hope to stimulate a more nuanced understanding and promote the development of more sex-responsive approaches in HF management.</p>}},
  author       = {{Arata, Allegra and Ricci, Fabrizio and Khanji, Mohammed Y. and Mantini, Cesare and Angeli, Francesco and Aquilani, Roberta and Di Baldassarre, Angela and Renda, Giulia and Mattioli, Anna Vittoria and Nodari, Savina and Gallina, Sabina}},
  issn         = {{2308-3425}},
  keywords     = {{gender medicine; guidelines; heart failure; menopause; pregnancy; sex; treatment}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of cardiovascular development and disease}},
  title        = {{Sex Differences in Heart Failure : What Do We Know?}},
  url          = {{http://dx.doi.org/10.3390/jcdd10070277}},
  doi          = {{10.3390/jcdd10070277}},
  volume       = {{10}},
  year         = {{2023}},
}