Table 3.

Summarized pathophysiology and therapy in women with HFpEF.

Hormonal	Bio-Hormonal	Risk Factors	Race	Therapy
Decreased estradiol	Higher angiotensin-converting enzyme serum activity in women	Obesity	White race, and not African American and Hispanic, was associated with HFpEF	Spironolactone-associated reduction in all-cause mortality was observed only in women
		Hypertension
Higher testosterone	Increased sympathetic nervous system activity in women	Diabetes	Obesity was reported as more important risk factor in African American women	Sex-specific differences regarding beta blockers and renin-angiotensin inhibitors in HFpEF have not been investigated so far
		Coronary heart disease
	Decreased nitric oxide bioavailability	Atrial fibrillation
		Anemia
	Increased prostaglandin and prostacyclin levels	Chronic obstructive pulmonary disease
	Oxidative stress	Renal dysfunction
		Chemo- and radiotherapy

HFpEF—heart failure with preserved ejection fraction.