Differences in presentation, diagnosis and management of heart failure in women. A scientific statement of the Heart Failure Association of the ESC

Author:

Rosano Giuseppe M.C.12,Stolfo Davide34,Anderson Lisa5,Abdelhamid Magdy6,Adamo Marianna7,Bauersachs Johann8,Bayes‐Genis Antoni9,Böhm Michael10,Chioncel Ovidiu1112,Filippatos Gerasimos13,Hill Loreena14,Lainscak Mitja1516,Lambrinou Ekaterini17,Maas Angela H.E.M.18,Massouh Angela R.19,Moura Brenda2021,Petrie Mark C.22,Rakisheva Amina23,Ray Robin24,Savarese Gianluigi425,Skouri Hadi26,Van Linthout Sophie2728,Vitale Cristiana24,Volterrani Maurizio2930,Metra Marco7,Coats Andrew J.S.31

Affiliation:

1. Chair of Pharmacology, Department of Human Sciences and Promotion of Quality of Life San Raffaele University of Rome Rome Italy

2. Cardiology San Raffaele Cassino Hospital Cassino Italy

3. Division of Cardiology, Cardiothoracovascular Department Azienda Sanitaria Universitaria Integrata di Trieste Trieste Italy

4. Division of Cardiology, Department of Medicine Karolinska Institutet Stockholm Sweden

5. Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute St. George's University of London and St George's University Hospitals NHS Foundation Trust London UK

6. Department of Cardiovascular Medicine, Faculty of Medicine, Kasr Al Ainy Cairo University Giza Egypt

7. ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy

8. Department of Cardiology and Angiology Hannover Medical School Hannover Germany

9. Heart Institute, Hospital Universitari Germans Trias i Poujol, CIBERCV Badalona Spain

10. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes Saarland University Homburg/Saar Germany

11. University of Medicine Carol Davila Bucharest Romania

12. Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’ Bucharest Romania

13. National & Kapodistrian University of Athens School of Medicine Athens University Hospital Attikon Chaidari Greece

14. School of Nursing and Midwifery Queen's University Belfast UK

15. Division of Cardiology General Hospital Murska Sobota Rakičan Slovenia

16. Faculty of Medicine University of Ljubljana Ljubljana Slovenia

17. Department of Nursing Cyprus University of Technology Limassol Cyprus

18. Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands

19. Hariri School of Nursing American University of Beirut Beirut Lebanon

20. Armed Forces Hospital Porto Portugal

21. Faculty of Medicine of University of Porto Porto Portugal

22. School of Cardiovascular and Metabolic Health University of Glasgow Glasgow UK

23. City Cardiological Center Almaty Kazakhstan Qonaev city hospital Almaty Region Kazakhstan

24. Department of Cardiology St George's Hospital London UK

25. Heart and Vascular and Neuro Theme Karolinska University Hospital Stockholm Sweden

26. Division of Cardiology Sheikh Shakhbout Medical city Abu Dhabi UAE

27. Berlin Institute of Health at Charité–Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT) Berlin Germany

28. German Center for Cardiovascular Research (DZHK), Partner site Berlin Berlin Germany

29. Department of Human Science and Promotion of Quality of Life San Raffaele Open University Rome Italy

30. Cardio‐Pulmonary Department IRCCS San Raffaele Rome Italy

31. Heart Research Institute Sydney NSW Australia

Abstract

AbstractDespite the progress in the care of individuals with heart failure (HF), important sex disparities in knowledge and management remain, covering all the aspects of the syndrome, from aetiology and pathophysiology to treatment. Important distinctions in phenotypic presentation are widely known, but the mechanisms behind these differences are only partially defined. The impact of sex‐specific conditions in the predisposition to HF has gained progressive interest in the HF community. Under‐recruitment of women in large randomized clinical trials has continued in the more recent studies despite epidemiological data no longer reporting any substantial difference in the lifetime risk and prognosis between sexes. Target dose of medications and criteria for device eligibility are derived from studies with a large predominance of men, whereas specific information in women is lacking. The present scientific statement encompasses the whole scenario of available evidence on sex‐disparities in HF and aims to define the most challenging and urgent residual gaps in the evidence for the scientific and clinical HF communities.

Publisher

Wiley

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