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Do Women Physicians Accept and Follow Heart Failure Guidelines More Than Men?

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Abstract

Purpose of Review

Our aim was to assess the degree of acceptance of the European Clinical Practice Guidelines (CPG) on heart failure (HF) among Spanish physicians according to sex. This was a cross-sectional study, employing Google Forms, conducted by a group of HF experts from the Region of Madrid (Spain), between November 2021 and February 2022, among specialists and residents of Cardiology, Internal Medicine, and Primary Care from Spain.

Recent Findings

A total of 387 physicians—173 women (44.7%)—from 128 different centers completed the survey. Compared to men, women were significantly younger (38.2 ± 9.1 years vs. 40.6 ± 11.2 years; p = 0.024) and had fewer years of clinical practice (12.1 ± 8.1 years vs. 14.5 ± 10.7 years; p = 0.014). Briefly, women and men had a positive opinion of the guidelines and thought that implementing quadruple therapy is feasible in less than 8 weeks. Women followed more frequently than men the new paradigm of “4 pillars at lowest doses” and considered more frequently the establishment of quadruple therapy before implanting a cardiac device. Although they agreed about “low blood pressure” as the major limitation for achieving quadruple therapy in heart failure with reduced ejection fraction, there were discrepancies on the second most frequent barrier, and women were more proactive when initiating SGLT2 inhibitors.

Summary

In a large survey including nearly 400 doctors from all over Spain to provide real-world opinion on 2021 ESC HF Guidelines and experience with SGLT2 inhibitors, women follow more frequently the new paradigm of “4 pillars at lowest doses”, consider more frequently the establishment of quadruple therapy before implanting a cardiac device, and were more proactive when initiating SGLT2 inhibitors. Further studies confirming an association of sex with a better compliance of HF guidelines are needed.

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Data Availability

Data can be available by request.

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Author information

Authors and Affiliations

  1. Cardiology Department, Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Universitario Ramón Y Cajal, Madrid, Spain

    Jesús Álvarez-García & Marta Cobo Marcos

  2. Cardiology Department, Hospital Universitario de Torrejon, Madrid, Spain

    María José Cristo Ropero

  3. Cardiology Department, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain

    Ángel Manuel Iniesta Manjavacas

  4. Cardiology Department, Hospital Universitario La Princesa, Madrid, Spain

    Pablo Díez-Villanueva

  5. Cardiology Department, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain

    Alberto Esteban-Fernández

  6. Cardiology Department, Hospital Universitario, Instituto de Investigación Sanitaria Hospital, 12 de Octubre12 de Octubre (imas12), Madrid, Spain

    Javier de Juan Bagudá

  7. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain Department of Medicine, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, Madrid, Spain

    Javier de Juan Bagudá

  8. Cardiology Department, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, Madrid, Spain

    Mercedes Rivas-Lasarte & Marta Cobo Marcos

  9. Cardiology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Mikel Taibo Urquía

  10. Cardiology Department, Hospital Central de La Defensa Gómez-Ulla, Madrid, Spain

    Juan Górriz-Magaña

  11. Cardiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain

    Josebe Goirigolzarri-Artaza & Ramón Bover Freire

  12. Cardiology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain

    Diego Iglesias del Valle

  13. Cardiology Department, Hospital Universitario Infanta Leonor, Madrid, Spain

    Cristina Beltrán Herrera

  14. Cardiology Department, Hospital Universitario del Sureste, Arganda del Rey, Madrid, Spain

    Adolfo Villa

  15. Cardiology Department, Hospital Universitario Fundación de Alcorcón, Madrid, Spain

    Raquel Campuzano Ruiz

  16. Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, Universidad Complutense, Calle Doctor Esquerdo, 46, 28007, Madrid, Spain

    Manuel Martínez-Sellés

Authors
  1. Jesús Álvarez-García
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  2. María José Cristo Ropero
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  17. Manuel Martínez-Sellés
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Corresponding authors

Correspondence to Jesús Álvarez-García or Manuel Martínez-Sellés.

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The survey was individual, voluntary, and anonymous; without collecting identifiable data, an Ethics Committee approval review was not required.

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The authors declare no competing interests.

Human and Animal Rights and Informed Consent

All reported studies with human subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Álvarez-García, J., Cristo Ropero, M.J., Iniesta Manjavacas, Á.M. et al. Do Women Physicians Accept and Follow Heart Failure Guidelines More Than Men?. Curr Heart Fail Rep 20, 151–156 (2023). https://doi.org/10.1007/s11897-023-00597-y

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