期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 79, 期 15, 页码 1530-1541出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2022.02.013
关键词
gender; heart failure; sex
资金
- National Institutes of Health [P30AG059988, P30DK092939]
- American Heart Association [19TPA34890060]
Sex-based differences in risk, symptoms, and management of heart failure exist, with women having a higher incidence of HF with preserved ejection fraction compared to men. However, there are gaps in understanding gender-based differences in HF and inadequate representation of women and gender minorities in clinical trials.
Sex-based differences exist in risk, symptoms, and management of heart failure (HF). Women have a higher incidence of HF with preserved ejection fraction compared with men. This may be partially caused by the cardiovascular effects of estrogen and sex-specific risk factors (eg, adverse pregnancy outcomes, premature menopause). Key gaps exist in understanding of gender-based differences in HF, which is a distinctly different concept than sex-based differences. Although evidence-based therapies for HF are available, only limited data address sex-specific efficacy, and no data address gender-based efficacy. Persistent shortcomings in representation of women and gender minority participants in clinical trials limit an actionable database. A comprehensive roadmap to close the sex/gender-based gap in HF includes the following: 1) sex/gender-specific personalized prevention; 2) sex/gender-neutral implementation of evidence-based therapies; and 3) sex/gender-appropriate policy-level initiatives to spur research assessing sex/gender-specific causes of HF; enhance sex/gender-specific subgroup reporting; and promote community engagement of these important patient cohorts. (c) 2022 by the American College of Cardiology Foundation.
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