A disease of her own? Unique features of heart failure in women

AbstractHeart failure (HF) is a significant and growing public health challenge for women. Compared with men, women tend to develop HF later in life and are more likely to experience HF with preserved ejection fraction. There are also significant sex differences in outcomes, with women reporting lower quality of life but overall better survival versus men. In this review, we summarize sex differences in traditional HF risk factors, such as hypertension, diabetes, obesity and coronary artery disease, as well as female-specific HF risk factors including menopause, pregnancy and adverse pregnancy outcomes, and breast cancer therapy. While our understanding of the sex-specific efficacy of HF therapy remains limited by the underrepresentation of women in major clinical trials, there is a suggestion of preferential benefit of specific agents for women. Further work is required to better understand the pathophysiology of HF in women uniquely and to increase representation of women in clinical trials.Keywords: Heart failurecardiovascular diseasesex differences Potential conflict of interestE. S. Lau reports previous advisory board service for Astellas Pharma.Source of fundingE. S. Lau is supported by grants from National Institutes of Health [K23-HL159243]; American Heart Association [853922]; Massachusetts General Hospital [MGH SPARK Award].