Background:To describe characteristics and outcomes in women and men with heart failure with preserved ejection fraction.Methods:Baseline characteristics (including biomarkers and quality of life) and outcomes (primary outcome: composite of first heart failure hospitalization or cardiovascular death) were compared in 4458 women and 4010 men enrolled in CHARM-Preserved (Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity) (EF≥45%), I-Preserve (Irbesartan in heart failure with Preserved ejection fraction), and TOPCAT-Americas (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial).Results:Women were older and more often obese and hypertensive but less likely to have coronary artery disease or atrial fibrillation. Women had more symptoms and signs of congestion and worse quality of life. Despite this, the risk of the primary outcome was lower in women (hazard ratio, 0.80 [95% CI, 0.73–0.88]), as was the risk of cardiovascular death (hazard ratio, 0.70 [95% CI, 0.62–0.80]), but there was no difference in the rate for first hospitalization for heart failure (hazard ratio, 0.92 [95% CI, 0.82–1.02]). The lower risk of cardiovascular death in women, compared with men, was in part explained by a substantially lower risk of sudden death (hazard ratio, 0.53 [0.43–0.65]; P<0.001). E/A ratio was lower in women (1.1 versus 1.2).Conclusions:There are significant differences between women and men with heart failure with preserved ejection fraction. Despite worse symptoms, more congestion, and lower quality of life, women had similar rates of hospitalization and better survival than men. Their risk of sudden death was half that of men.Clinical Trial Registration:URL: https://www.clinicaltrials.gov. Unique identifier: NCT00853658, NCT01035255.

中文翻译：

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心力衰竭与保留射血分数的性别相关差异。

妇女有更多的症状和充血症状，生活质量较差。尽管如此，女性的主要结局风险较低（危险比，0.80 [95％CI，0.73–0.88]），以及心血管死亡的风险（危险比率，0.70 [95％CI，0.62-0.80]） ），但因心力衰竭的首次住院率没有差异（危险比为0.92 [95％CI，0.82-1.02]）。与男性相比，女性心血管死亡的风险较低，部分原因是猝死的风险大大降低（危险比为0.53 [0.43-0.65]；92 [95％CI，0.82-1.02]。与男性相比，女性心血管死亡的风险较低，部分原因是猝死的风险大大降低（危险比为0.53 [0.43-0.65]；92 [95％CI，0.82-1.02]。与男性相比，女性心血管死亡的风险较低，部分原因是猝死的风险大大降低（危险比为0.53 [0.43-0.65]；P <0.001）。女性的E / A比值较低（1.1比1.2）。结论：患有心力衰竭且射血分数保持不变的男性和女性之间存在显着差异。尽管症状更糟，交通更加拥挤，生活质量降低，但女性的住院率和生存率均高于男性。他们突然死亡的风险是男性的一半。临床试验注册：URL：https：//www.clinicaltrials.gov。唯一标识符：NCT00853658，NCT01035255。