Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA.
Cardiovascular Research Center and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Climacteric. 2024 Feb;27(1):32-40. doi: 10.1080/13697137.2023.2256673. Epub 2024 Jan 15.
Heart failure (HF) is a significant and growing public health challenge for women. Compared with men, women tend to develop HF later in life and are more likely to experience HF with preserved ejection fraction. There are also significant sex differences in outcomes, with women reporting lower quality of life but overall better survival versus men. In this review, we summarize sex differences in traditional HF risk factors, such as hypertension, diabetes, obesity and coronary artery disease, as well as female-specific HF risk factors including menopause, pregnancy and adverse pregnancy outcomes, and breast cancer therapy. While our understanding of the sex-specific efficacy of HF therapy remains limited by the underrepresentation of women in major clinical trials, there is a suggestion of preferential benefit of specific agents for women. Further work is required to better understand the pathophysiology of HF in women uniquely and to increase representation of women in clinical trials.
心力衰竭（HF）是女性面临的重大且日益严峻的公共卫生挑战。与男性相比，女性往往在晚年才患上 HF，并且更有可能出现射血分数保留型 HF。在结局方面也存在显著的性别差异，女性报告的生活质量较低，但总体生存率优于男性。在这篇综述中，我们总结了传统 HF 风险因素中的性别差异，如高血压、糖尿病、肥胖和冠状动脉疾病，以及女性特有的 HF 风险因素，包括绝经、妊娠和不良妊娠结局以及乳腺癌治疗。尽管女性在主要临床试验中的代表性不足限制了我们对 HF 治疗的性别特异性疗效的理解，但有一些证据表明某些特定药物对女性更有益。需要进一步的工作来更好地了解女性 HF 的独特病理生理学，并增加女性在临床试验中的代表性。
