A Retrospective Comparative Study of Sex-Based Risk Variations in Heart Failure With Preserved Ejection Fraction (HFpEF) Versus Heart Failure With Reduced Ejection Fraction (HFrEF) Article Swipe

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Medicine Ejection fraction Heart failure Cardiology Internal medicine Heart failure with preserved ejection fraction Retrospective cohort study Stroke volume

Kristen Yeh , Muhammad Ansar , Hera Jamal , Jack A. Cannon , Subhadra Thampi , Reghu Menon , Oasima Muner , Anika Pruthi , Pooja D. Patel , Tabitha Jaison , Houston Ward , Sarah Kim , Ryan Wilde , Christopher M. Snyder , David Cheng , Joseph Ragan , Hunter Gogoj , Krystal Hunter , Satyajeet Roy ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1177/21501319251367840 · OA: W4413434679

Introduction/Objectives: The prevalence of heart failure (HF) in the United States is currently at an all-time high and is predicted to rise to 8.5 million by 2030. Development of HF differs between men and women. We examined the risk factors associated with HF in women compared to men. Methods: A retrospective medical record review of adult men and women with HF. Variables were compared between women and men with Heart failure with Preserved Ejection Fraction (HFpEF) or Heart Failure with Reduced Ejection Fraction (HFrEF). Results: There were 460 women with HFpEF (WHFpEF) and 258 men with HFpEF (MHFpEF). Higher prevalences were observed in WHFpEF group compared to the MHFpEF group for older age (82.2 ± 9.5 vs 80.6 ± 9.6 years; P = .029), asthma (34.3 vs 20.2%; P < .001), osteoarthritis (66.5 vs 50.0%; P < .001), depression (39.6 vs 23.6%; P < .001), hypothyroidism (38.0 vs 17.1%; P < .001), and anxiety (43.0 vs 20.9%; P < .001). Greater odds of HFpEF in women was observed with increasing age per year (OR = 1.043, 95% CI = 1.027-1.059; P < .001), increasing BMI (OR = 1.037, 95% CI = 1.018-1.056; P < .001), rheumatological disorder (OR = 1.920, 95% CI = 1.457-2.530; P < .001), mental health disorder, such as depression or anxiety (OR = 1.898, 95% CI = 1.459-2.470; P < .001), asthma (OR = 1.807, 95% CI = 1.350-2.420; P < .001), and hypothyroidism (OR = 1.973, 95% CI = 1.486-2.618; P < .001). Among HFrEF patients, 225 patients were in WHFrEF group and 250 patients were in MHFrEF group. Higher prevalences were observed in WHFrEF group compared to the MHFrEF group for asthma (26.7 vs 16.8%; P = .009), depression (40.0 vs 22.0%; P < .001), hypothyroidism (32.0 vs 20.0%; P = .003), and anxiety (32.9 vs 21.6%; P = .006). Greater odds of HFrEF in women was noted for Black race (OR = 1.455, 95% CI = 1.018-2.080; P = .039). Conclusion: In women with HF, old age, elevated BMI and osteoarthritis are associated with HFpEF; Black race is associated with HFrEF; while asthma, depression, anxiety, and hypothyroidism are associated with both HFpEF and HFrEF.