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Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?

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Abstract

Purpose of Review

Heart failure (HF) is one of the most frequent causes of hospital admission in elderly patients, especially in women, who present a high prevalence of geriatric syndromes like frailty. Studies have suggested that frailty and its impact may also differ between males and females. Understanding how frailty may differently affect HF patients depending on sex is therefore imperative for providing personalized care. The aim of this review is to summarize the role of sex in the prognostic impact of frailty in HF patients.

Recent Findings

Numerous studies have identified frailty as a significant predictor of all-cause mortality and hospital readmissions. A recent study of elderly HF out-patients demonstrated that while women had a higher prevalence of frailty, it was an independent predictor of mortality and readmission only in men. Moreover, another study revealed that physical frailty was associated with time to first clinical event among men but not among women. These results raise the question about why frailty affects differently HF prognosis in men and women.

Summary

Women with HF present a higher prevalence of frailty, especially when it is considered as physical decline. Nevertheless, frailty affects differently HF prognosis in men and women. Women with HF present lower mortality than men and frailty is related with prognosis only in men. The different severity of HF between men and women and other hormonal, psychosocial, and clinical factors might be involved in this fact.

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Data Availability

The data that support the findings of this study are available from the corresponding author, JAPR, upon reasonable request.

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Acknowledgements

Spanish Section of Geriatric Cardiology, for the support.

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Authors and Affiliations

  1. Department of Cardiology, Hospital Universitario de Burgos, Avda. Islas Baleares, 3. 09005, Burgos, Spain

    Lara Aguilar-Iglesias & Jose-Angel Perez-Rivera

  2. Department of Cardiology, Hospital Universitario Puerta del Mar, Cádiz, Spain

    Ana Perez-Asensio & Cesar Jimenez-Mendez

  3. Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain

    Lidia Vilches-Miguel & Pablo Diez-Villanueva

  4. Facultad de Ciencias de La Salud, Universidad Isabel I, Burgos, Spain

    Jose-Angel Perez-Rivera

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All authors wrote the main manuscript (LAI and JAP section 1 and 2, PDV and LVM section 3 and 4 and CJM and APA section 5 and abstract). JAPR coordinated the process and corrected the final document. PDV and LVM prepared the table. LAI corrected the English and prepared the references. CJM and APA prepared the figures. All authors reviewed the manuscript.

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Correspondence to Jose-Angel Perez-Rivera.

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Aguilar-Iglesias, L., Perez-Asensio, A., Vilches-Miguel, L. et al. Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?. Curr Heart Fail Rep 21, 131–138 (2024). https://doi.org/10.1007/s11897-024-00650-4

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