Do Women Physicians Accept and Follow Heart Failure Guidelines More Than Men?

• Published in: Current heart failure reports Vol. 20; no. 3; pp. 151 - 156
• Main Authors: Álvarez-García, Jesús, Cristo Ropero, María José, Iniesta Manjavacas, Ángel Manuel, Díez-Villanueva, Pablo, Esteban-Fernández, Alberto, de Juan Bagudá, Javier, Rivas-Lasarte, Mercedes, Taibo Urquía, Mikel, Górriz-Magaña, Juan, Cobo Marcos, Marta, Goirigolzarri-Artaza, Josebe, Iglesias del Valle, Diego, Bover Freire, Ramón, Beltrán Herrera, Cristina, Villa, Adolfo, Campuzano Ruiz, Raquel, Martínez-Sellés, Manuel
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2023
• Subjects: Cardiac Surgery; Cardiology; Cross-Sectional Studies; Female; Heart Failure - drug therapy; Humans; Imaging; Internal Medicine; Male; Medicine; Medicine & Public Health; Physicians, Women; Radiology; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Stroke Volume; Topical Collection on Sex and Gender Aspects in Heart Failure; Vascular Surgery; Heart failure; Women; Clinical practice guidelines; Survey; Review; Sex
• ISSN: 1546-9530; 1546-9549
• DOI: 10.1007/s11897-023-00597-y

Purpose of Review
Our aim was to assess the degree of acceptance of the European Clinical Practice Guidelines (CPG) on heart failure (HF) among Spanish physicians according to sex. This was a cross-sectional study, employing Google Forms, conducted by a group of HF experts from the Region of Madrid (Spain), between November 2021 and February 2022, among specialists and residents of Cardiology, Internal Medicine, and Primary Care from Spain.
Recent Findings
A total of 387 physicians—173 women (44.7%)—from 128 different centers completed the survey. Compared to men, women were significantly younger (38.2 ± 9.1 years vs. 40.6 ± 11.2 years;
p
 = 0.024) and had fewer years of clinical practice (12.1 ± 8.1 years vs. 14.5 ± 10.7 years;
p
 = 0.014). Briefly, women and men had a positive opinion of the guidelines and thought that implementing quadruple therapy is feasible in less than 8 weeks. Women followed more frequently than men the new paradigm of “4 pillars at lowest doses” and considered more frequently the establishment of quadruple therapy before implanting a cardiac device. Although they agreed about “low blood pressure” as the major limitation for achieving quadruple therapy in heart failure with reduced ejection fraction, there were discrepancies on the second most frequent barrier, and women were more proactive when initiating SGLT2 inhibitors.
Summary
In a large survey including nearly 400 doctors from all over Spain to provide real-world opinion on 2021 ESC HF Guidelines and experience with SGLT2 inhibitors, women follow more frequently the new paradigm of “4 pillars at lowest doses”, consider more frequently the establishment of quadruple therapy before implanting a cardiac device, and were more proactive when initiating SGLT2 inhibitors. Further studies confirming an association of sex with a better compliance of HF guidelines are needed.