Heart failure in women.
Congestive heart failure represents a growing health issue with significant morbidity, expense, and mortality. Unfortunately, despite heart failure affecting men and women equally, women historically have represented a minority in heart failure trials. Despite this disparity, treatment decisions rely heavily on these trials. Women with heart failure often have different clinical features than men, such as age of onset and comorbidities. Compared with men, women also demonstrate differences in remodeling and the response to injury, such as volume or pressure overload and myocardial infarction. We are only beginning to understand the clinical implications of these gender differences and their impact on pharmacologic treatments. After discussing these differences, a review of the agents useful in systolic failure is made, including angiotensin-converting enzyme inhibitors, b-blockers, digoxin, and aldosterone inhibition. Treatment of diastolic heart failure with empiric guidelines follows.
Silber
David H
DH
Division of Cardiology, Penn State College of Medicine, Milton S. Hershey Medical Center, PA 17033, USA. dsilber@psu.edu
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D017668:Age of Onset; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015897:Comorbidity; D004077:Digoxin / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011379:Prognosis; D012737:Sex Factors; D016387:Women's Health
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D004077:Digoxin