The Canadian journal of cardiology

1916-70753742021AprThe Canadian journal of cardiologyCan J CardiolSex-Specific Differences in Heart Failure: Pathophysiology, Risk Factors, Management, and Outcomes.560571560-57110.1016/j.cjca.2020.12.025S0828-282X(20)31196-XHeart failure (HF) is a leading cause of hospitalisation, morbidity, and mortality in Canada. There are sex-specific differences in the etiology, epidemiology, comorbidities, treatment response, and treatment adverse effects that have implications on outcomes in HF. Sex-specific analyses of some HF trials indicate that optimal doses of drug therapies and benefit of device therapies may differ between male and female patients, but the trials were not designed to test sex differences. The under-representation of female participants in HF randomised controlled trials (RCTs) is a major limitation in assessing the sex-specific efficacy and safety of treatments. To ensure that female patients receive safe and effective HF therapies, RCTs should include participants proportionate to the sex-specific distribution of disease. This review outlines the sex-specific differences in HF phenotype and treatment response, and highlights disparities in services and gaps in knowledge that merit further investigation.Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.SullivanKristenKDepartment of Medicine, Division of Cardiology, McMaster University, Hamilton, Ontario, Canada; Cardiology Postgraduate Program, McMaster University, Hamilton, Ontario, Canada.DoumourasBarbara SBSHeart Failure and Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.SantemaBernadet TBTDepartment of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.WalshMary NorineMNSt Vincent Heart Center, Indianapolis, Indiana, USA.DouglasPamela SPSDuke University Medical Center/Duke Clinical Research Institute, Durham, North Carolina, USA.VoorsAdriaan AAADepartment of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.Van SpallHarriette G CHGCDepartment of Medicine, Division of Cardiology, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton, Ontario, Canada; Cardiovascular Research Program, Institute for Clinical Evaluative Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: harriette.vanspall@phri.ca.engCIHRCanadaJournal ArticleResearch Support, Non-U.S. Gov'tReview20201229