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Sex-Dependent Differences in the Diagnosis, Treatment and Causes of Heart Failure

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Biology of Women’s Heart Health

Part of the book series: Advances in Biochemistry in Health and Disease ((ABHD,volume 26))

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Abstract

The impact of heart failure on women’s health is only now being fully realized. There has previously been a mistaken belief that heart failure was predominantly a man’s condition. However, research has demonstrated that the causes and treatments of heart failure differ between males and females. Females are exposed to unique stresses on their cardiovascular system (hypertensive disorders of pregnancy, gestational diabetes and chemotherapy for breast cancer) that can ultimately lead to increased risk of heart failure. As well, risk factors such as diabetes can have a larger impact in females as compared to males. Effective treatment for female heart failure patients has been hindered by challenges in accurately diagnosing the disease, the lack of relevant preclinical models, a historic underrepresentation of females in clinical trials and a lack of treatments for heart failure with preserved ejection fraction, the most common form of heart failure in females. Biological differences between males and females can account for some of the differences observed in heart failure outcomes but sex dependent impacts of social determinants of health can also account for some of the adverse outcomes for females with heart failure. In this review we will briefly describe the two major subtypes of heart failure and the use of new biomarkers to more effectively diagnose heart failure. We also discuss four specific risk factors for heart failure that predominantly affect heart failure incidence in females, the impacts of social determinants of health on heart failure risk, and how women may be more adversely impacted by them. Finally, we will propose approaches to narrow the gap in heart failure treatment for females in the future.

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Authors and Affiliations

  1. Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

    Jessica A. M. McBride

  2. Department of Biochemistry and Medical Genetics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Jeffrey T. Wigle

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  1. The Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

    Lorrie Kirshenbaum

  2. The Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

    Inna Rabinovich-Nikitin

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McBride, J.A.M., Wigle, J.T. (2023). Sex-Dependent Differences in the Diagnosis, Treatment and Causes of Heart Failure. In: Kirshenbaum, L., Rabinovich-Nikitin, I. (eds) Biology of Women’s Heart Health. Advances in Biochemistry in Health and Disease, vol 26. Springer, Cham. https://doi.org/10.1007/978-3-031-39928-2_16

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