Disparities in Heart Failure and other Cardiovascular Diseases among Women

Abstract

This article reviews literature pertinent to cardiovascular disparities in women, focusing primarily on heart failure (HF). It provides an in-depth look at causes, biological influences, self-management and lack of adherence to HF-treatment guidelines in women. Disparities in treatment of causative factors of HF, such as myocardial infarction and hypertension, contribute to women having poorer HF outcomes than men. This article discusses major contributing reasons for nonadherence to medication regimes for HF in women, including advanced age at time of diagnosis, likelihood of multiple comorbidities, lack of social support and low socioeconomic status. Limited inclusion of women in clinical trials and the scarcity of gender analyses for HF and other cardiovascular diseases continues to limit the applicability of research findings to women.

Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan

“…We have found a higher frequency of ICD carriers in men, probably due to the higher prevalence of ischemic heart disease. Inequality in the treatment administered to female patients with HFrEF has been previously reported as women receive fewer evidence-based medications due to several reasons that include advanced age, comorbidities, socioeconomic status, and limited inclusion of women in clinical trials [18]. This disparity has also been reported with cardiac devices, as women are less likely to receive an ICD or cardiac resynchronization [18] than men.…”

“…Inequality in the treatment administered to female patients with HFrEF has been previously reported as women receive fewer evidence-based medications due to several reasons that include advanced age, comorbidities, socioeconomic status, and limited inclusion of women in clinical trials [18]. This disparity has also been reported with cardiac devices, as women are less likely to receive an ICD or cardiac resynchronization [18] than men. However, we found a high adherence to guideline-recommended drugs in both sexes, at similar doses, including the starting and last recorded dose of SV.…”

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

“…The severity of CAD is often underestimated in women compared with men, possibly because of the likelihood for an atypical presentation to CAD for women 31. When diagnosed with CAD, women are less likely than men to undergo cardiac catheterization and revascularization 32. This is an important observation, especially since patients with HFpEF with incomplete revascularization displayed greater deterioration in EF and increased mortality 8.…”

Gender Differences in the Application of Spanish Criteria for Initiation of Enzyme Replacement Therapy for Fabry Disease in the Fabry Outcome Survey

“…Evidence from the literature suggests that females are referred less often for diagnostic interventions and treated less aggressively than males [33]. Furthermore, disparities in treatment between genders have been consistently identified for heart [36] and kidney diseases [31,37], among others [32]. …”