Heart failure & cardiomyopathiesMeta-analysis
Sex differences in pharmacological treatment of heart failure: a meta-analysis of randomized trials
- Systematic review and meta-analysis of randomised trials
- random-effects
- meta-regression
Systematic search up to 21 March 2025; 5749 publications screened
Authors' conclusion
These findings suggest that pharmacological efficacy in HF does not differ by sex and that historical female underrepresentation in trials is unlikely to have masked important sex differences.
Study context
- Population
- Randomized controlled trials (RCTs) (≥100 patients) of pharmacological heart failure (HF) treatments vs placebo or usual care with clinical events as primary outcome
- Participants
- 292,027 participants · 139 RCTs
- Comparison
- Women vs Men
- Outcome
- Sex differences in the primary efficacy endpoint (relative effect measures, REM)
Pooled result
As reported in the abstract
Sex difference in treatment efficacy (delta ln[REM])
Delta ln[relative effect measures (REM)]
0.00
95% CI −0.04 to 0.03
P = 0.85
Further pooled results
Meta-regression: proportion of women vs sex differences in REM, overall efficacy, other clinical outcomes
- No association with sex differences in REM (78 RCTs)
- P = 0.25
- No association with overall efficacy (139 RCTs)
- P = 0.24
- No association with other clinical outcomes
Original publication
Sex differences in pharmacological treatment of heart failure: a meta-analysis of randomized trials. Eur Heart J. Published 28 April 2026. doi:10.1093/eurheartj/ehag311
Summarised from the published abstract; every number is checked against it