State-of-the-Art Paper
Heart Failure in Women: A Need for Prospective Data

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Heart failure affects 5 million Americans, and nearly 50% of these are women. Sex differences have been noted regarding the underlying etiology, pathophysiology, and prognosis. Women are less likely to have coronary artery disease and more likely than men to have hypertension and valvular disease as the underlying etiology. They often present at an older age with better systolic function than men. For both sexes, there is significant morbidity, but age-adjusted data reveal that women have a better survival. Despite these known sex differences, medical management recommendations are the same for women and men, because prospective sex-specific clinical trials have not been performed. However, our review raises some concerns that women might respond differently to therapy.

Key Words

heart failure
sex
women

Abbreviations and Acronyms

ACEI
angiotensin-converting enzyme inhibitor
ARB
angiotensin receptor blocker
CAD
coronary artery disease
CI
confidence interval
CVD
cardiovascular disease
HF
heart failure
HR
hazard ratio
ICD
implantable cardioverter-defibrillator
LV
left ventricular
LVEF
left ventricular ejection fraction
NIH
National Institutes of Health
NYHA
New York Heart Association
PPCM
peripartum cardiomyopathy
RR
relative risk

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This work was supported by American Heart Association Scientist Development Grant 0730307N.