Crousillat Daniela R, Ibrahim Nasrien E
Massachusetts General Hospital, 55 Fruit Street GRB-800, Boston, MA, 02114, USA.
Harvard Medical School, Boston, MA, USA.
Curr Treat Options Cardiovasc Med. 2018 Sep 21;20(11):88. doi: 10.1007/s11936-018-0687-y.
Heart failure (HF) is prevalent among women and remains a leading cause of morbidity and mortality in the United States. Currently, 3 million women live with HF and the prevalence is projected to continue to increase. The purpose of this review is to highlight sex differences in the use and response to evidence-based pharmacological, device, and advanced HF therapies, as well as explore emerging areas of research in sex differences in the treatment of HF.
Under-representation of women in clinical HF trials has limited our understanding of sex-related differences in the treatment and outcomes of HF. Important sex differences exist in the use of evidence-based HF therapies and clinical response among women with HF. In general, women tend to obtain the same clinical benefit from evidence-based HF drug and device therapies, but the utilization rates of guideline-directed medical therapies remain poor compared to men. Future research efforts should focus on increasing the enrollment of women in HF trials to help gain helpful insight into sex-specific differences in treatment effects and subsequent clinical outcomes.
心力衰竭(HF)在女性中普遍存在,在美国仍然是发病和死亡的主要原因。目前,有300万女性患有HF,预计患病率将继续上升。本综述的目的是强调在使用循证药理学、器械和晚期HF治疗方法以及对其反应方面的性别差异,并探索HF治疗中性别差异的新兴研究领域。
女性在临床HF试验中的代表性不足,限制了我们对HF治疗和结局中性别相关差异的理解。在循证HF治疗方法的使用以及HF女性患者的临床反应方面存在重要的性别差异。总体而言,女性往往能从循证HF药物和器械治疗中获得相同的临床益处,但与男性相比,指南指导的药物治疗利用率仍然较低。未来的研究应致力于增加女性参与HF试验的人数,以帮助深入了解治疗效果和后续临床结局中的性别特异性差异。