Why do women with heart failure have a better prognosis than men?

Sex-dependent differences in progression to heart failure

Dr Kenneth MacLeod and his team at Imperial College London are investigating why high blood pressure causes heart failure in more women than men, yet more women survive. Heart failure is a serious condition where the heart cannot pump blood around the body effectively because it is too weak or stiff. It is usually caused by a heart attack, high blood pressure or heart muscle diseases called cardiomyopathies. Until recently, researchers thought treatments for high blood pressure and heart failure work equally well in men and women. But differences in the prognosis of heart failure in men versus women suggest that this is probably not true, and that the heart responds differently to stress in women and men. Dr MacLeod believes the female sex hormone oestrogen could protect the heart. He thinks that when oestrogen levels are low, the heart is more prone to remodel itself in response to stress, and to start failing. Drugs that boost oestrogen could, he believes, prevent this. In this project, Dr MacLeod and his team will find out if oestrogen prevents or slows heart tissue remodelling and ultimately the development of heart failure. He will investigate why male and female hearts respond differently to high blood pressure, and how oestrogen and its receptors are involved. This research could reveal new ways to prevent or slow the onset of heart failure, and could lead to different treatments to manage heart failure in men and women.