Women with
Heart Failure

Woman with heart failure campaign

Cardiovascular disease (CVD) is the leading cause of death for women in Europe and worldwide. Not only does heart disease account for one-third of women’s deaths globally, but they suffer from worse outcomes and higher mortality than in men.1


Under-Representation of Women with Heart Failure

Heart failure (HF) is a chronic and progressive disease where the heart is too weak or stiff to either relax or contract properly.1 This can develop when the heart is affected by a heart attack or other conditions that cause insufficient blood flow and the demands of oxygen and nutrients are not met. For patients with HF, fluid builds up in the lungs and legs, making daily activities difficult due to fatigue and shortness of breath.1

The incidence of heart failure is increasing, particularly among women, and constitutes a rapidly growing public health problem.2

Patients with heart failure nearly doubled worldwide from 33.5 million in 1990 to 64.3 million in 2017,3 with higher prevalence in women and patients over 60 years of age.4 Furthermore, between the ages of 65 and 85 years, it is estimated that the incidence of HF triples in women with each 10-year increase, whereas the rate of incidence of HF doubles in the same time frame among men.2 Increase in disease progression may be due to insufficient awareness among women and physicians of sex-specific symptoms and presentation of CVD.5

two older women laughing together

While women have a significantly lower incidence rate of heart failure compared to men (at all age categories except >74 years), they still account for approximately half of the prevalent cases; notably HFpEF is more common in women.6

In Sweden, the prevalence of Chronic HF has been estimated to be 2.5% overall, and was recorded as the cause of death in 3.4% of women and 2.4% of men. The estimated mortality in Sweden was higher in women than in men (3.2 and 3.0/1000 person-years, respectively).7 In the Swede-HF registry, women accounted for 55% of all HFpEF patients and only 29% of all HFrEF patients.6




Only 26%

of the HF patient population enrolled in Randomized Controlled Trials were women, despite the clinical burden.8

illustration of three men on the right and one woman on the left highlighted in yellow

Despite the other advancements within women’s health, this percentage has not changed.

2000 —

25.5% of randomized controlled trial patients were women

2006 —

FDA approved the first HPV vaccine

2010 —

Improvements in breast cancer screenings

2012 —

27.4% decrease in the number of women smoking since 1985

2016 —

women's life expectancy is 3.6 years longer than men's

2019 —

26.3% of randomized controlled trial patients were women

What’s Next: Recognize the Symptoms


  1. Cardiovascular Disease in Women (escardio.org)
  2. [2019 - JACC Heart Fail - Daubert - Primary Prevention of Heart Failure in Women] JACC Heart Fail. 2019 Mar;7(3):181-191. doi: 10.1016/j.jchf.2019.01.011.
  3. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Heart-failure-cases-soar-globally
  4. https://amj.amegroups.com/article/view/5475/html
  5. [Heart disease deaths rising in young women. ESc press release, 10 Feb 2021]
  6. Groenewegen et al.; Epidemiology of heart failure; European Journal of Heart Failure (2020) 22, 1342–1356. doi:10.1002/ejhf.1858
  7. Zarrinkoub et al.; The epidemiology of heart failure, based on data for 2.1 million inhabitants in Sweden; 2013; European Journal of Heart Failure (2013) 15, 995–1002. doi:10.1093/eurjhf/hft064.
  8. Whitelaw et al; Trial characteristics associated with under-enrolment of females in randomized controlled trials of heart failure with reduced ejection fraction: a systematic review. European Journal of Heart Failure (2021) 23, 15-24 . doi:10.1002/ejhf.2034.
  9. Ljubojević S. The human papillomavirus vaccines. Acta Dermatovenerol Croat. 2006;14(3):208.
  10. https://www.womenshealth.gov/30-achievements/05. Accessed April 19, 2023
  11. Filion, K. B., Steffen, L. M., Duval, S., Jacobs, D. R., Jr, Blackburn, H., & Luepker, R. V. (2012). Trends in smoking among adults from 1980 to 2009: the Minnesota heart survey. American journal of public health, 102(4), 705–713. https://doi.org/10.2105/AJPH.2011.300162
  12. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/healthstatelifeexpectanciesuk/2016to2018. Accessed April 19, 2023


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