Although sex-related differences in the epidemiology, risk factors, clinical characteristics and outcomes of heart failure are well known, investigations in the past decade have shed light on an often overlooked aspect of heart failure: the influence of sex on treatment response. Sex-related differences in anatomy, physiology, pharmacokinetics, pharmacodynamics and psychosocial factors might influence the response to pharmacological agents, device therapy and cardiac rehabilitation in patients with heart failure. In this Review, we discuss the similarities between men and women in their response to heart failure therapies, as well as the sex-related differences in treatment benefits, dose–response relationships, and tolerability and safety of guideline-directed medical therapy, device therapy and cardiac rehabilitation. We provide insights into the unique challenges faced by men and women with heart failure, highlight potential avenues for tailored therapeutic approaches and call for sex-specific evaluation of treatment efficacy and safety in future research.

尽管心力衰竭的流行病学、危险因素、临床特征和结果方面与性别相关的差异是众所周知的，但过去十年的研究揭示了心力衰竭一个经常被忽视的方面：性别对治疗反应的影响。解剖学、生理学、药代动力学、药效学和心理社会因素方面的性别相关差异可能会影响心力衰竭患者对药物、设备治疗和心脏康复的反应。在这篇综述中，我们讨论了男性和女性对心力衰竭治疗反应的相似性，以及治疗益处、剂量反应关系以及指南指导的药物治疗、器械治疗的耐受性和安全性方面的性别相关差异。和心脏康复。我们深入了解男性和女性心力衰竭患者面临的独特挑战，强调定制治疗方法的潜在途径，并呼吁在未来的研究中对治疗效果和安全性进行针对性别的评估。