Gender Related Issues in the Management of Heart Failure

Stefan      Anker; Giuseppe      Caminiti; Maurizio      Volterrani

Abstract

Heart failure (HF) represents a growing health issue with significant morbidity, expense, and mortality in western world. Despite a similar prevalence between gender our knowledge about this disease mostly come from studies perfomed in men. Instead, until now women have been under-represented in HF trials and this limits our knowledge of HF in women to extrapolation of findings from men. However according to the available data women with HF differ from men regarding pathophysiology, clinical presentation and prognosis. Women with HF often present at an older age, have a better systolic function, suffer from more comorbidities, have an higher rate of hospital admissions and have a better age-adjusted survival compared to men. Moreover pharmacodynamic specificities related to gender have been described. Taken together these gender-related differences can affect response to several kinds of treatments and the general clinical approach to the patient by the physician. The understanding of these differences may improve the clinicalmanagement of HF and possible new gender-specific diagnostic and therapeutic options may be developed. To this aim, it remains mandatory. to increase the number of female patients with HF enrolled in clinical trials.

Keywords: Heart failure, gender, management, epidemiology, Amiodarone, ventricular, pharmacokinetics, aetiology, diastolic, myocyte, angiotensin, antimitogenic, natriuretic, Prognosis, Bisoprolol, norepinephrine, bradykinin, spironolactone