Guideline-Directed Medical Therapy in Females with Heart Failure with Reduced Ejection Fraction

Curr Heart Fail Rep. 2021 Oct;18(5):284-289. doi: 10.1007/s11897-021-00524-z. Epub 2021 Jul 2.


Purpose of review: This narrative review synthesizes sex differences in guideline-directed medical therapy (GDMT) use and response among female patients with heart failure with reduced ejection fraction (HFrEF), discusses female representation in HFrEF clinical trials, and outlines future areas of investigation to reduce sex disparities in HFrEF care globally.

Recent findings: Observational registries suggest sex-specific disparities persist in GDMT rates, and there may be key sex-specific differences in optimal dosing of GDMT in HFrEF patients. Underrepresentation of female patients in HF clinical trials is a key barrier, and sex disparities in HF clinical trial leadership may influence sex-specific knowledge generation of medical management of HFrEF patients. There are important sex-specific differences in GDMT use and response among female HFrEF patients that warrant further study. Increasing female representation in HFrEF clinical trials, diversifying HF trial leadership, and embedding sex-specific approaches in the lifecycle of research from conception to reporting are essential to decreasing sex disparities in clinical care of all HFrEF patients.

Keywords: Guideline-directed medical therapy; Heart failure with reduced ejection fraction; Sex.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Female
  • Heart Failure* / drug therapy
  • Humans
  • Male
  • Registries
  • Stroke Volume
  • Ventricular Dysfunction, Left*