Intermountain Healthcare

Heart Failure and Women


Salt Lake City, UT -- (ReleaseWire) -- 09/09/2021 --Heart failure affects increasing numbers of older women, but it's becoming easier to prevent and treat, said Rebecca Cable, NP, a cardiovascular nurse practitioner at the Intermountain Healthcare Heart Institute.

When discussing cardiovascular catastrophes, heart attack and stroke leap to mind. "We're less likely to think of heart failure, though it affects more than 3.6 million women and is the leading reason for hospitalization -- and a major cause of death -- in women over 65," said Cable.

The term "heart failure" evokes an image of a suddenly silent heart, but the condition is better described as a gradual decline in the heart's ability to pump and circulate blood.

Like other muscles in the body, the heart weakens over the years. Cable said for most people, the effects are subtle: color fades from the cheeks; hands grow cold; you begin to nod off earlier in the evening. But for the one percent of people over 65 who develop heart failure, a decline in the supply of oxygenated blood to organs and tissues can eventually jeopardize the lungs, kidneys, and liver.

Heart failure affects about 3.6 million women in the United States. Despite the fact that women account for nearly 50 percent of all hospital admissions for heart failure, only 25 percent of women are involved in heart failure studies.

"The number one thing you can do to lower your risk of heart disease happens when you're younger which is have a healthy lifestyle, healthy diet," said Cable.

Differences of women with heart failure as compared to men with heart failure:

– Women tend to develop congestive heart failure at an older age than men.

– Women tend to develop diastolic heart failure with a more normal ejection fraction than men. Ejection fraction is the measurement of how much blood is being pumped out of the left ventricle of the heart.

Heart failure can occur due to a weakened heart muscle (systolic heart failure) or may be related to a stiff, inflexible heart muscle (diastolic heart failure). In some cases the ejection fraction can be normal, but due to the increased pressures inside the heart and lungs, the patient can have heart failure.

– The causes of heart failure in women are often linked to high blood pressure, coronary artery disease, valvular disease, and diabetes mellitus.

– Although rare, peripartum cardiomyopathy is a cause of heart failure unique to women. Peripartum cardiomyopathy is the rare development of heart failure within the last month of pregnancy, or within five months after delivery. Peripartum cardiomyopathy occurs without an identifiable cause.

– Depression is frequently associated with heart failure and is more common in women than men.

– Although the signs and symptoms of heart failure are the same among men and women, women tend to have more symptoms such as shortness of breath and more difficulty exercising than men.

– In general, women survive longer than men with heart failure.

Cable said heart failure usually doesn't have a single cause; instead, several factors or conditions act in concert to erode heart function. The problem may originate in either the right ventricle, which pumps blood into the lungs, where it picks up oxygen, or the left ventricle, which pumps oxygen-rich blood to the body's tissues.

In either case, the heart can't do the work needed to supply adequate blood to all parts of the body. The ventricle may be too stiff to relax enough between contractions and thus unable to fill completely (diastolic failure), or it may not contract strongly enough to expel most of the blood it holds (systolic failure).

Like coronary artery disease, heart failure may take a slightly different course in women than in men. The landmark Framingham Heart Study has followed the development of heart failure in three generations of men and women and catalogued the risk factors. The researchers found that any of the conditions listed below can set the stage for heart failure, but some are more likely culprits in women.

"Heart failure can be the great mimicker a lot of people have symptoms that are very nonspecific," said Cable. "Sometimes you just notice that you are really short of breath when you are doing activities. You are more fatigued than you would expect to be and you have swelling in weird places."

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Intermountain Healthcare is a nonprofit system of 25 hospitals, 225 clinics, a Medical Group with 2,600 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Utah, Idaho, and Nevada. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery. For more information about Intermountain, visit, read our blogs, or follow us on Twitter, Facebook, Instagram, LinkedIn, and YouTube.