Is Heart Failure Research Failing Women?

Ivanhoe Broadcast News

(Ivanhoe Newswire) ? Going way beyond Mars and Venus, the differences between men and women in their risk for developing heart failure (HF) and their prognosis are striking.

Men and women may also respond differently to treatment, raising serious concerns about current practices and reinforcing the urgency for gender-specific clinical trials, according to a review article.

In the last decade, major multicenter HF trials on average included only 28 percent women.

"Current practice is to treat heart failure similarly in men and women," Eileen Hsich, M.D., director of the Women's Heart Failure Clinic at the Cleveland Clinic in Ohio was quoted as saying. "Yet, our review of published reports suggests compelling sex differences, not only in terms of how and when heart failure develops, but also possible responses to treatments and how the disease impacts quality of life."

The data show that HF?a life-threatening condition in which the heart cannot pump enough blood throughout the body?affects women at an older age and often with a stronger heart compared to men. Hypertension and valvular disease are more likely the culprits for HF in women, whereas men are more likely to have coronary artery disease (CAD) as the underlying cause. And while women live longer with the disease, they also tend to have lower quality of life than men due to greater physical limitations with exercise, more HF-related hospital stays and depression.

"The reasons why survival is better for women remain unclear, but it may be due to differences in the underlying disease," said Dr. Hsich. "Our findings also raise questions as to whether certain diagnostic tests or criteria need to be changed to better reflect how HF presents in female versus male patients."

There is evidence that gender-specific differences may result when performing a cardiopulmonary stress test, which is often used to evaluate patients for heart transplantation. Women with HF tend to have a better prognosis for any given peak oxygen consumption value compared to men, yet the cut-off values to determine the need for a heart transplant are the same for both sexes. The potential benefits of certain HF therapies, both in terms of reducing morbidity and mortality, appear to be different in women.