2021 | HFSA

Sex Matters (in Heart Failure)

HFSA News Journal of Cardiac Failure

ROCKVILLE, MARYLAND (November 12, 2021) - Researchers have found that numerous sex differences exist in heart failure (HF) with women facing additional risk factors; yet there are no sex-specific recommendations for the prevention, treatment, and management of heart failure. 

“Our comprehensive review of the literature highlights substantial gaps in knowledge as to sex differences in heart failure. Specific calls to action have been outlined whereby these gaps can be addressed in efforts to advance and personalize HF care by sex,” said Dr. Anuradha Lala-Trindade, lead author and associate professor of medicine and director of heart failure research at Mount Sinai Hospital in New York City. 

HF is on the rise, affecting over 2.6 million women, with the risk increasing with age and a lifetime risk of heart failure developing in approximately 1 in 3 women.  Risk factors including hypertension, diabetes, obesity and smoking disproportionately increase the risk for HF particularly with preserved ejection fraction (HFpEF) in women. Additionally, there are sex-specific risk factors, including conditions related to pregnancy, therapies for breast cancer, and higher prevalence of autoimmune diseases like lupus which can be linked to incident HF. Interestingly, differential responses to stress may elicit HF presentation as in the case of spontaneous coronary artery dissection (SCAD) and stress or takatsubo cardiomyopathy. 

Researchers also discovered that the current HF classification system has no sex-specific cut-offs for the way heart function is measured. The classic measure of ejection fraction, which is a percentage of the amount of blood in your heart that the heart is able to pump out, may vary by sex, but the thresholds used are not sex-specific. Medications prescribed for HF have very different effects in women compared with men and women continue to be underrepresented in most HF clinical trials, more than any other cardiovascular disease state.

Further study of these sex differences and the inclusion of women in heart failure clinical trials will result in precision therapies tailored to the individual patient, when sex is taken into account. 

“Identifying which women may be at a higher risk for heart failure can help providers develop a more effective approach for prevention,” said senior author Dr. Martha Gulati, a cardiologist and president-elect of the American Society for Preventive Cardiology.

The paper Sex Differences in Heart Failure was published in the Journal of Cardiac Failure, the official journal of the Heart Failure Society of America (HFSA) and the Japanese Heart Failure Society (JHFS). It can be accessed online: https://www.onlinejcf.com/article/S1071-9164(21)00432-2/fulltext 

Coauthors: Drs. Upsana Tayal, Carine Hamo, Quentin Youmans, Sana Al-Khatib, Biykem Bozkurt, Melinda B. Davis, James Januzzi, Robert Mentz, Andrew Sauer, Mary Norine Walsh, and Clyde Yancy


About the Heart Failure Society of America 

The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers and patients. For more information, visit hfsa.org

About the Journal of Cardiac Failure 

Launched in 1994 and a joint endeavor by the Heart Failure Society of America and the Japanese Heart Failure Society, the Journal of Cardiac Failure publishes peer-reviewed manuscripts of interest to clinicians and researchers in the field of heart failure and related disciplines. These include original communications of scientific importance and review articles involving clinical research, health services and outcomes research, animal studies, and bench research with potential clinical applications to heart failure. The Journal also publishes manuscripts that report the design of ongoing clinical trials and editorial perspectives that comment on new developments pertinent to the field of heart failure or manuscripts published in other journals. Visit the JCF online

Media Contact:  

Laura Poko: Director of Marketing and Communications, Heart Failure Society of America, 301-798-4493, ext. 226 lpoko@hfsa.org