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Factors Improving Prognosis in Women:

In general, women have:

  • Better ventricular function [5][6]

  • Less ischemic heart disease [2][7]

  • Less ventricular fibrillation [7]

  • Less ventricular arrhythmias [8]

  • An attenuated sympathetic activation and parasympathetic withdrawal [9]

  • A protective response to LV overload pressure [10]

Women tend to suffer from diastolic failure, as opposed to the systolic failure more commonly experienced in males [1]. Every 1% increase in LVEF results in a 4% decrease in mortality for women, but only a 1% decrease in men [11]

 

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1. Mejhert M, Holmgren J, Wandell P, Persson H, Edner M. Diagnostic tests, treatment and follow-up in heart failure patients - is there a gender bias in the coherence to guidelines? European Journal of Heart Failure. 1999;1:407-410.

2. Ho KK, Anderson KM, Kannel WB, GRoossman W, Levy D. Survival after the onset of congestive cardiac failure in Framingham Heart study subjects. Circulation 1993;88:107-15.

5. Samuel RS, Hausdorff HM, Wei JY. Congestive heart failure with preserved systolic function: is it a women's disease? Women's Health Issues 1999;9:219-22.

6. Lindenfeld J, Krause-Steinrauf H, Salerno J. Where are all the women with heart failure? J Am Coll Cardiol 1997;30:1417-9.

7. Adams KF, Dunlap SH, Sueta CA, Clarke SW, Patterson JH, Blauwet M, Jensen LR, Tomasko L. Relation between gender, etiology and survival in patients with symptomatic heart failure. J Am Coll Cardiol. 1996;28:1781-8.

8. Manolio TA, Furberg CD, Rautaharju PM, Siscovick D, Newman AB, Borhani NO, Gardin JM, Tabatznik B. Cardiac arrhythmias on 24-h ambulatory electrocardiography in older men and women. The Cardiovascular Health Study. J Am Coll Cardiol. 1994;23:916-25.

9. Aronson D, Burger A. Gender-related differences in modulation of heart rate in patients with congestive heart failure. J Cardiovasc Electrophys 2000;11:1071-7.

10. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldmanmd AM, Francis GS, Ganiats TG, Goldstein S, Gregoratos G, Jessup ML, Noble RJ, Packer M, Silver MA, Stevenson LW, Gibbons RJ, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Jacobs AK, Hiratzka LF, Russell RO, Smith SC Jr.ACC yAHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary.A report of the American College of CardiologyyAmerican Heart Association Task Force on practice guidelines. (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration with the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America.Cir culation 2001;104:2996 –3007.

11. Ghali JK, Krause-Steinrauf HJ, Adams KF, Khan SS, Rosenberg YD, Yancy CW, Young JB, GOldman S, Peberdy MA, Lindenfeld J. Gender Differences in Advaned Heart Failure: Insights from the BEST Study. Journal of the American College of Cardiology. 2003;42(12):2128-34

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