Sex‐Specific Outcomes and Treatment Responses in Elderly Patients With Heart Failure With Preserved Ejection Fraction: A Comprehensive Single‐Center Retrospective Study

09 Jun 20264 min read4 viewsJournal Feed

GIST (Key Takeaways)

Journal of the American Heart Association, Volume 15, Issue 12 , June 16, 2026. Background. Heart failure with preserved ejection fraction (HFpEF) disproportionately affects elderly women, with potential contributions from sex‐specific hormonal and physiological factors. We aimed to evaluate sex‐specific prognostic differences, comorbidity impacts, and guideline‐directed medical therapy effects in elderly patients with HFpEF.Methods.
Retrospective analysis of 603 patients (age ≥60 years, male: 51.6%, mean age: 79.10±9.19 years) newly diagnosed with HFpEF at Huadong Hospital, Fudan University (from July 2019 to June 2024) with follow‐up through December 2024. The primary outcome was all‐cause mortality. Results. The overall mortality rate was 14.2/100 person‐years (women: 15.4 versus men: 13.2).
Based on the gender and etiology phenotype classification for HFpEF, patients with types I/IV HFpEF had better survival (10.0/12.4 per 100 person‐years) versus those with types II/III/V (17.1/22.9/24.2 per 100 person‐years). Sex‐specific mortality peaks differed, with men having type V in 30.3/100 person‐years and women having type III in 28.2/100 person‐years. In Cox regression analysis, after adjusting for age, sex, body mass index, and hypertension, type 2 diabetes and stages 4 or 5 chronic kidney disease predicted mortality in men only (chronic kidney disease 4 or 5: hazard ratio [HR], 3.24, type 2 diabetes: HR, 2.34; both adjustedP 0.1). After adjusting for age, body mass index, hypertension, type 2 diabetes, and renal dysfunction, angiotensin receptor neprilysin inhibitors reduced mortality in women (HR, 0.57; adjustedP=0.027), while sodium‐glucose cotransporter‐2 inhibitors reduced mortality in men (HR, 0.25; adjustedP=0.021).Conclusions.
Mortality patterns, comorbidity impacts, and treatment responses in elderly patients with HFpEF exhibit significant sex disparities. This underscores the need for sex‐tailored management to optimize outcomes. These findings should be interpreted with caution given the retrospective design.

Clinical Editorial

Journal of the American Heart Association published a clinical update in Cardiology on 09 Jun 2026. The item focuses on Sex‐Specific Outcomes and Treatment Responses in Elderly Patients With Heart Failure With Preserved Ejection Fraction: A Comprehensive Single‐Center Retrospective Study. Open the detail page to review the full original feed content.