Sex differences in diagnosis and treatment of heart failure: toward precision medicine

There are sex-related differences in the pathophysiology and phenotype of heart failure (HF) as well as the pharmacokinetics and pharmacodynamics of drugs between women and men due to biological differences, such as heart and vessel size, response to blood volume and pressure, body water and muscle...

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Main Authors: Soo Yong Lee, Seong-Mi Park
Format: Article
Language:English
Published: The Korean Association of Internal Medicine 2025-03-01
Series:The Korean Journal of Internal Medicine
Subjects:
Online Access:http://kjim.org/upload/kjim-2024-338.pdf
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author Soo Yong Lee
Seong-Mi Park
author_facet Soo Yong Lee
Seong-Mi Park
author_sort Soo Yong Lee
collection DOAJ
description There are sex-related differences in the pathophysiology and phenotype of heart failure (HF) as well as the pharmacokinetics and pharmacodynamics of drugs between women and men due to biological differences, such as heart and vessel size, response to blood volume and pressure, body water and muscle compositions, and dominant sex hormones. Therefore, target drug doses required to achieve the same clinical effect differ between the sexes, while there may also be sex-related differences in side effects of a given drug at the same dose. These biological differences have been reflected in the results of clinical trials. Moreover, women have been underrepresented in pharmacological therapy trials as well as having lower device implantation rates than men. Therefore, the currently recommended target doses of medications based on clinical trials may not be appropriate for women. Although guidelines for HF have been standardized since the last major revision in 2021, most do not differentiate by sex. This review focuses on evidence regarding sex-related differences in multiple aspects of HF, including epidemiology, pathophysiology, clinical features, treatment, and prognosis, highlighting the need for sex-specific treatment guidelines.
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publisher The Korean Association of Internal Medicine
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spelling doaj-art-ee35098f1dde43b0923ca87117098fa82025-08-20T03:03:08ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482025-03-0140219620710.3904/kjim.2024.338171003Sex differences in diagnosis and treatment of heart failure: toward precision medicineSoo Yong Lee0Seong-Mi Park1 Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea Division of Cardiology, Anam Hospital, Korea University College of Medicine, Seoul, KoreaThere are sex-related differences in the pathophysiology and phenotype of heart failure (HF) as well as the pharmacokinetics and pharmacodynamics of drugs between women and men due to biological differences, such as heart and vessel size, response to blood volume and pressure, body water and muscle compositions, and dominant sex hormones. Therefore, target drug doses required to achieve the same clinical effect differ between the sexes, while there may also be sex-related differences in side effects of a given drug at the same dose. These biological differences have been reflected in the results of clinical trials. Moreover, women have been underrepresented in pharmacological therapy trials as well as having lower device implantation rates than men. Therefore, the currently recommended target doses of medications based on clinical trials may not be appropriate for women. Although guidelines for HF have been standardized since the last major revision in 2021, most do not differentiate by sex. This review focuses on evidence regarding sex-related differences in multiple aspects of HF, including epidemiology, pathophysiology, clinical features, treatment, and prognosis, highlighting the need for sex-specific treatment guidelines.http://kjim.org/upload/kjim-2024-338.pdfheart failurewomensex differences
spellingShingle Soo Yong Lee
Seong-Mi Park
Sex differences in diagnosis and treatment of heart failure: toward precision medicine
The Korean Journal of Internal Medicine
heart failure
women
sex differences
title Sex differences in diagnosis and treatment of heart failure: toward precision medicine
title_full Sex differences in diagnosis and treatment of heart failure: toward precision medicine
title_fullStr Sex differences in diagnosis and treatment of heart failure: toward precision medicine
title_full_unstemmed Sex differences in diagnosis and treatment of heart failure: toward precision medicine
title_short Sex differences in diagnosis and treatment of heart failure: toward precision medicine
title_sort sex differences in diagnosis and treatment of heart failure toward precision medicine
topic heart failure
women
sex differences
url http://kjim.org/upload/kjim-2024-338.pdf
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AT seongmipark sexdifferencesindiagnosisandtreatmentofheartfailuretowardprecisionmedicine