Comorbidities in Heart Failure: Are There Gender Differences?
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Compared to men, women with heart failure (HF) are often older, smoke less, and have more preserved ejection fraction (EF) and hypertensive HF rather than HF of ischemic etiology. Gender-stratified outcomes on comorbidities data in HF are scarce. Women have traditionally been underrepresented in HF trials. Although data suggest that overall prognosis may be better in women, they experience lower quality of life with greater functional impairment from HF compared to men. Gender differences have been reported for comorbid diabetes, chronic obstructive pulmonary disease, renal dysfunction, anemia, and depression and may explain gender disparity in outcomes. However, possible confounding of comorbidities with known prognostic determinants in HF (such as EF) as well as gender differences in the utilization of medical therapies obscures interpretation. In this review, we will explore the evidence for gender differences in non-cardiovascular comorbidities in HF. Our findings may guide clinicians to individualize HF care, according to best practice, in the hope of improving prognosis for this chronic and debilitating condition.
KeywordsHeart failure Ejection fraction Comorbidity Diabetes Anemia COPD Renal dysfunction Arthritis
Compliance with Ethical Standards
Conflict of Interest
Robert Mentz receives research support from the NIH, Amgen, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Gilead, Novartis, Otsuka, and ResMed; honoraria from HeartWare, Janssen, Luitpold Pharmaceuticals, Novartis, ResMed, and Thoratec; and has served on an advisory board for Luitpold Pharmaceuticals, Inc.
Thomas von Lueder has received research support from the South-Eastern Norwegian Health Authority and honoraria from Novartis and has served on advisory boards for Vifor and Novartis.
Dipak Kotecha has received professional development support from Daiitchi Sankyo, research grants from Menarini, and is the Lead for the Beta-blockers in Heart Failure Collaborative Group (BB-meta-HF).
Ingrid Hopper and Ken Lee Chin report no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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