Skill Checkup: A Woman With Long‐standing Hypertension and Worsening Dyspnea on Exertion

Yasmine S. Ali, MD

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December 23, 2021

HFpEF accounts for half of heart failure cases today and is predicted to be the predominant form of hospitalized HF over the next decade.

Women are disproportionately affected by HFpEF, outnumbering men 2:1. Sex-specific maladaptations to hypertensive aging in women may underlie the greater risk for HFpEF.

For patients with HFpEF, there is not yet an optimal treatment modality so deciding on appropriate treatment is actually more difficult than for HFrEF. HFrEF mostly occurs in men and is partly the consequence of cardiomyocyte loss. In contrast, HFpEF is often diagnosed in older women with a cluster of comorbidities, such as hypertension, type 2 diabetes, anemia, pulmonary disease, and kidney disease.

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