Key result
Women have a nearly double lifetime risk of developing HFpEF compared to HFrEF, driven by distinct pathophysiological mechanisms and traditional risk factors that necessitate tailored management.
Why the study?
Women have a nearly double lifetime risk of HFpEF compared to HFrEF, with distinct sex-specific risk factors, pathophysiology, and therapeutic responses, yet significant knowledge gaps persist.
This review highlights the unique traditional and sex-specific risk factors contributing to the development of HFpEF in women, emphasizing the need for sex-specific prevention and management strategies.
Supports sex-specific HFpEF risk assessment; leaves open targeted prevention and therapy trials in women.
Heart failure with preserved ejection fraction (HFpEF) represents a major clinical challenge with rising global prevalence. Women have a nearly double lifetime risk of developing HFpEF compared to heart failure with reduced ejection fraction (HFrEF). In HFpEF, sex differences emerge both in how traditional cardiovascular risk factors (such as hypertension, obesity, and diabetes) affect cardiac function and through distinct pathophysiological mechanisms triggered by sex-specific events like menopause and adverse pregnancy outcomes. These patterns influence not only disease development, but also therapeutic responses, necessitating sex-specific approaches to treatment. This review aims to synthesize existing knowledge regarding HFpEF in women including traditional and sex-specific risk factors, pathophysiology, presentation, and therapies, while outlining important knowledge gaps that warrant further investigation. The impact of HFpEF spans a woman's entire lifespan, requiring prevention and management strategies tailored to different life stages. While understanding of sex-based differences in HFpEF has improved, significant knowledge gaps persist. Through examination of current evidence and challenges, this review highlights promising opportunities for innovative research, therapeutic development, and clinical care approaches that could transform the management of HFpEF in women.
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Agrawal et al. (2025) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Sex-specific and traditional risk factor management was evaluated. Women have a nearly double lifetime risk of developing HFpEF compared to HFrEF, driven by distinct pathophysiological mechanisms and traditional risk factors that necessitate tailored management.
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