Heart Failure in Women

Shannon Donovan • 15 November 2021
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Did you know that heart failure affects about 3.6 million women in the United States? The lifetime risk of developing coronary artery disease is 1 in 2 for men and 1 in 3 for women, but by the age of 40, men and women have equal lifetime risks of developing heart failure. At age 40 men and women have a lifetime risk of 1 in 5 of developing heart failure. 

There are some differences with heart failure in women when compared to men: 

  • 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. 
  • 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. 
  • 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.

Even though women do not usually develop heart failure related to heart attacks, women can still develop atherosclerosis (progressive narrowing of the arteries) also known as coronary artery disease. In fact, although women with congestive heart failure develop coronary artery disease less often than men the frequency is still so high that it is the second leading cause for women with heart failure. It is important to remember that women often have atypical symptoms such as shortness of breath, as compared to men whose primary symptom is often chest pain. Therefore, women like men need to be evaluated for blockages in the arteries.

Women with breast cancer who have been treated with chemotherapy including doxorubicin (Adriamycin) can also develop congestive heart failure due to the toxic effects that these drugs can have on the heart muscle (called drug toxicity).

Another cause of congestive heart failure unique to women is peripartum cardiomyopathy. Peripartum cardiomyopathy is the rare development of heart failure within the last month of pregnancy or within five months after delivery. The cause of peripartum cardiomyopathy remains unknown.

With the right care, heart failure will not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.

Your health care team will help you manage your condition and help you stay on track with your heart failure treatment plan. It is important to keep regular follow-up appointments with your health care team, as well as to take your medications as prescribed, make dietary changes and live an active and healthy lifestyle.

Reference: https://my.clevelandclinic.org/health/diseases/17078-heart-failure-in-women

Bozkurt, B., & Khalaf, S. (2017). Heart Failure in Women. Methodist DeBakey cardiovascular journal, 13(4), 216–223. https://doi.org/10.14797/mdcj-13-4-216