Heart Failure Different in Women

July 27, 2009 -- Women with heart failure live longer than men with the disease, but they have more illness and hospitalizations and poorer overall quality of life, a review of the research shows.

The analysis confirms that men and women often have different risk factors for developing heart failure, and it suggests that responses to treatment may also vary by gender.

But study co-author Eileen M. Hsich, MD, of Cleveland Clinic’s Women’s Heart Failure Clinic, says far too little is known about how gender affects treatment because women are still underrepresented in clinical studies and most heart failure trials do not report results in a sex-specific way.

“These treatments must be working because women are living longer than men, but we don’t know as much as we should about this,” she tells WebMD.  “In order to change the future, more women with heart failure or any cardiovascular disease, need to be aggressive about participating in studies. They should not wait for their doctor to approach them.”

Half of Heart Failure Patients Are Women

According to the American Heart Association, about 5.3 million Americans are living with heart failure, and half of them are women.

Heart failure describes the inability of the heart to pump enough blood to meet the body’s demands.

It be caused by a weakened heart muscle that doesn’t contract with enough force to push blood out to the body (systolic heart failure) or because the pumping chamber does not relax properly, reducing the amount of blood available to enter the heart (diastolic heart failure).

According to the review, which appears in the Aug. 4 issue of the Journal of the American College of Cardiology, about 70% of men with heart failure have a weakened heart muscle as the cause, compared to about 40% of women.

Women are more likely than men to have high blood pressure and heart valve damage as the cause of heart failure; men are more likely to have coronary artery disease.

But when women do develop coronary artery disease, they are more likely than men to also develop heart failure.

In one national survey, which included more than 8,000 women with heart failure, more than a fourth (27%) had high blood pressure and just 3% had coronary artery disease.

But having coronary artery disease was more likely to lead to heart failure among women than high blood pressure.

Other sex-specific differences identified in the review included:

• As with heart disease in general, women tend to be older than men when they develop heart failure.
• Survival among women with heart failure is better than for men with the disease. The reasons for this remain unclear.
• Women with heart failure are more likely to be sicker than men and have more hospital stays. They are also more likely to suffer from depression than men.