Key result
Women have a nearly double lifetime risk of developing HFpEF compared to HFrEF, necessitating sex-specific approaches to prevention, treatment, and management across the lifespan.
Why the study?
Women have a nearly double lifetime risk of developing HFpEF compared to HFrEF with distinct sex-specific mechanisms and therapeutic responses, but significant knowledge gaps persist in its prevention and management.
This review highlights the distinct pathophysiological mechanisms and risk factors for HFpEF in women, emphasizing the need for sex-specific therapeutic and preventive strategies.
Sex differences may warrant tailored HFpEF evaluation; leaves open dedicated trials to guide sex-specific therapies.
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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Barbieri et al. (2025) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Women have a nearly double lifetime risk of developing HFpEF compared to HFrEF, necessitating sex-specific approaches to prevention, treatment, and management across the lifespan.
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