Women and Heart Failure

Heart Failure and Women

Heart failure affects about 3.6 million women in the United States. Despite the fact that women account for nearly 50% of all hospital admissions for heart failure, only 25% of women are involved in heart failure studies. Consequently, advances in heart failure therapies apply to most men, but have not been adequately studied in women.

Differences of women with heart failure as compared to men with heart failure:

  • Women tend to develop congestive heart failure at an older age than men.
  • Women tend to develop diastolic heart failure with a more normal ejection fraction than men. Ejection fraction is the measurement of how much blood is being pumped out of the left ventricle of the heart. Heart failure can occur due to a weakened heart muscle (systolic heart failure) or may be related to a stiff, inflexible heart muscle (diastolic heart failure). In some cases the ejection fraction can be normal, but due to the increased pressures inside the heart and lungs, the patient can have heart failure. Learn more
  • The causes of heart failure in women are often linked to high blood pressure, coronary artery disease, valvular disease, and diabetes mellitus.
  • Although rare, peripartum cardiomyopathy is a cause of heart failure unique to women. Peripartum cardiomyopathy is the rare development of heart failure within the last month of pregnancy, or within five months after delivery. Peripartum cardiomyopathy occurs without an identifiable cause.
  • Depression is frequently associated with heart failure and is more common in women than men.
  • Although the signs and symptoms of heart failure are the same among men and women, women tend to have more symptoms such as shortness of breath and more difficulty exercising than men.
  • In general, women survive longer than men with heart failure.

Clinical Trials

Heart Failure Clinical Trials and Women
Study Number of Women % Women/Total Patients
MERIT-HF 898 23
SOLVD Treatment 2568 20
SOLVD Prevention 548 13
RALES 446 27
EPHESUS 1918 29
DIG 1519 22
CIBIS II 515 19
COPERNICUS 469 20
CHARM - Overall 2400 32
CHARM - Preserved 1212 40
ELITE - II 966 31
Val-HEFT 1033 20
COMPANION 493 32
MIRACLE 145 32
MUSTIC 47 26
A-HEFT 421 40
V-HEFT 0 0
CARE-HF 216 27

Dr. Eileen Hsich, specialist in Women & Heart Failure

References

  1. AHA. Heart Disease and Stroke Stats-2009 Update. Dallas, Tx: AHA; 2009 *
  2. Redfield MM, Jacobsen SJ, Burnett JC Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA. 2003 Jan 8;289(2):194-202. *
  3. Vasan R, Larson M, Benjamin E, Evans J, Reiss C, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction. Journal of the American College of Cardiology. 1999; 33 (7): 1948-1955.*
  4. Masoudi F, Havranek E, Smith G; Fish R; Steiner J; Ordin D; Krumholz H. Gender, age, and heart failure with preserved left ventricular systolic function. Journal of the American College of Cardiology. 2003; 41 (2): 217-223.*
  5. Lund L, Mancini D. Heart failure in women. The Medical Clinics of North America. 2004; 88: 1321-1345.*
  6. Pearson G, Veille JC, Rahimtoola S; Hsia J, Oakley C, Hosenpud, J, Ansari A, Baughman KL. Peripartum Cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop Recommendations and Review. Journal of the American Medical Association. 2000; 283 (9): 1183-1188. *
  7. Gottlieb SS, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B, Marshall J, Minshall S, Robinson S, Fisher ML, Potenza M, Sigler B, Baldwin C, Thomas SA. The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology. 2004; 43: 1542-1549.*
  8. Johnstone D, Limacher M, Rousseau M, Liang CS, Ekelund L, Herman M, Stewart D, Guillotte M, Bjerken G, Gaasch W, et al. Clinical characteristics of patients in studies of left ventricular dysfunction (SOLVD). The American Journal of Cardiology. 1992; 70: 894-900.*
  9. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, Murabito JM, Vasan RS. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002 Oct 31;347(18):1397-402. *
  10. Roger VL, Weston SA, Redfield MM, Hellermann-Homan JP, Killian J, Yawn BP, Jacobsen SJ. Trends in heart failure incidence and survival in a community-based population. Journal of the American Medical Association. 2004; 292: 344-350. *

*a new browser window will open with this link. The inclusion of links to other web sites does not imply any endorsement of the material on the web sites or any association with their operator

written with Dr. Eileen Hsich, specialist in Women & Heart Failure

Reviewed: 10/16