Sex differences in heart failure

Gianluigi Savarese, Domenico D'Amario

Research output: Chapter in Book/Report/Conference proceedingChapter


Heart failure (HF) represents a global pandemic health problem with a high impact on health-care costs, affecting about 26 million adults worldwide. The overall HF prevalence and incidence are ~2% and ~0.2% per year, respectively, in Western countries, with half of the HF population with reduced ejection fraction (HFpEF) and half with preserved (HFpEF) or mid-range ejection fraction (HFmrEF). Sex differences may exist in HF. More males have HFrEF or HFmrEF and an ischemic etiology, whereas more females have HFpEF and hypertension, diastolic dysfunction, and valvular pathologies as HF etiologies. Females are generally older, have a higher EF, higher frequency of HF-related symptoms, and lower NYHA functional status. Generally, it is observed that female HF patients tend to have more comorbidities such as atrial fibrillation, diabetes, hypertension, anemia, iron deficiency, renal disease, arthritis, frailty, depression, and thyroid abnormalities. However, overall, females have better prognosis in terms of mortality and hospitalization risk compared with men, regardless of EF. Potential sex differences in HF characteristics may be underestimated because of the underrepresentation of females in cardiovascular research and, in particular, the sex imbalance in clinical trial enrollment may avoid to identify sex-specific differences in treatments’ benefit.
Original languageEnglish
Title of host publicationSex-Specific Analysis of Cardiovascular Function
Number of pages16
Publication statusPublished - 2018
Externally publishedYes

Publication series



  • Comorbidities
  • Comorbidity
  • Female
  • Health Status Disparities
  • Healthcare Disparities
  • Heart Failure
  • Heart failure
  • Humans
  • Incidence
  • Male
  • Pathophysiology
  • Prevalence
  • Prognosis
  • Risk Factors
  • Sex Characteristics
  • Sex Factors
  • Sex differences
  • Treatments
  • Ventricular Function, Left


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