Journal
CIRCULATION RESEARCH
Volume 130, Issue 4, Pages 436-454Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCRESAHA.121.319900
Keywords
cardiomyopathies; estrogens; heart failure; peripartum; women
Funding
- Akcea Therapeutics
- National Medical Research Council of Singapore
- Bayer
- Roche Diagnostics
- National Heart, Lung and Blood Institute of the National Institute of Health [R01HL141892]
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Heart failure exhibits sex differences in epidemiology, management, response to treatment, and outcomes across various cardiomyopathies. These differences are influenced by the cellular effects of sex hormones and perpetuated by implicit bias leading to undertreatment and underrepresentation in clinical trials.
Heart failure affects over 2.6 million women and 3.4 million men in the United States with known sex differences in epidemiology, management, response to treatment, and outcomes across a wide spectrum of cardiomyopathies that include peripartum cardiomyopathy, hypertrophic cardiomyopathy, stress cardiomyopathy, cardiac amyloidosis, and sarcoidosis. Some of these sex-specific considerations are driven by the cellular effects of sex hormones on the renin-angiotensin-aldosterone system, endothelial response to injury, vascular aging, and left ventricular remodeling. Other sex differences are perpetuated by implicit bias leading to undertreatment and underrepresentation in clinical trials. The goal of this narrative review is to comprehensively examine the existing literature over the last decade regarding sex differences in various heart failure syndromes from pathophysiological insights to clinical practice.
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