ArticleHeart (British Cardiac Society)2021
Heart failure medication dosage and survival in women and men seen at outpatient clinics.
Article in Heart (British Cardiac Society), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Achieved dose and treatment discontinuation of candesartan in men and women with chronic heart failure: data from CHARM.ESC heart failure · 2024Trial
- Redesigning cardiovascular medicine around sex differences.Nature medicine · 2026Review
- Women's heart disease research in the netherlands: angina with non-obstructive coronary artery disease and beyond.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Review
- Sex-specific association of cardiovascular drug doses with adverse outcomes in atrial fibrillation.Open heart · 2024Article
- Teaching gender medicine can enhance the quality of healthcare.American heart journal plus : cardiology research and practice · 2024Article
- Drug stewardship in chronic kidney disease to achieve effective and safe medication use.Nature reviews. Nephrology · 2024Review
- The effect of the four pharmacological pillars of heart failure on haemoglobin level.Annals of medicine and surgery (2012) · 2024Review
- Implications of Sex Differences on the Treatment Effectiveness in Heart Failure with Reduced Ejection Fraction Related to Clinical Endpoints and Quality of Life.Current heart failure reports · 2024Review
- A roadmap for sex- and gender-disaggregated health research.BMC medicine · 2023Article
- Sex-specific Mendelian randomisation to assess the causality of sex differences in the effects of risk factors and treatment: spotlight on hypertension.Journal of human hypertension · 2023Review
- Plasma Proteomic Patterns Show Sex Differences in Early Concentric Left Ventricular Remodeling.Circulation. Heart failure · 2023Article
- The Representation of Females in Studies on Antihypertensive Medication over the Years: A Scoping Review.Biomedicines · 2023Article
- Diastolic dysfunction and sex-specific progression to HFpEF: current gaps in knowledge and future directions.BMC medicine · 2022Review
- Daily ambulatory remote monitoring system for drug escalation in chronic heart failure with reduced ejection fraction: pilot phase of DAVID-HF study.European heart journal. Digital health · 2022Article
- Moving the Paradigm Forward for Prediction and Risk-Based Primary Prevention of Heart Failure in Special Populations.Current atherosclerosis reports · 2022Review
- Update on Management of Cardiovascular Diseases in Women.Journal of clinical medicine · 2022Review
- Addressing persistent evidence gaps in cardiovascular sex differences research - the potential of clinical care data.Frontiers in global women's health · 2022Article
- Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWomen with heart failure with reduced ejection fraction (HFrEF) may reach optimal treatment effect at half of the guideline-recommended medication dose. This study investigates prescription practice and its relation with survival of patients with HF in daily care.
methodsElectronic health record data from 13 Dutch outpatient cardiology clinics were extracted for HF receiving at least one guideline-recommended HF medication. Dose changes over consecutive prescriptions were modelled using natural cubic splines. Inverse probability-weighted Cox regression was used to assess the relationship between dose (reference≥50% target dose) and all-cause mortality.
resultsThe study population comprised 561 women (29% HFrEF (ejection fraction (EF)<40%), 49% heart failure with preserved ejection fraction (EF≥50%); HFpEF and 615 men (47% and 25%, respectively). During a median follow-up of 3.7 years, 252 patients died (48% women; 167 HFrEF, 84 HFpEF). Nine hundred thirty-four patients (46% women) received ACE inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), 795 (48% women) beta blockers and 178 (42% women) mineralocorticoid receptor antagonists (MRAs). In both sexes, the mean target dose across prescriptions was 50% for ACEI/ARBs and beta blockers, and 100% for MRAs. ACEI/ARB dose of <50% was associated with lower mortality in women but not in men with HFrEF. This was not seen in patients with HFpEF. Beta-blocker dose was not associated with all-cause mortality.
conclusionPatients with HF seen in outpatient cardiology clinics receive half of the guideline-recommended medication dose. Lower ACEI/ARB dose was associated with improved survival in women with HFrEF. These results underscore the importance of (re)defining optimal medical therapy for women with HFrEF.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.