Holistic Heart Health: HFpEF in Women Unraveled

In this Heart Failure Podcast episode, CardioNerds Academy members Drs. Anna Radakrishnan and Apoorva Gangavelli welcome two leaders in cardiology—Dr. Martha Gulati and Dr. Anu Lala—to explore heart failure with preserved ejection fraction (HFpEF) in women. This episode highlights how HFpEF in women is a complex, multisystem disorder influenced by both traditional risk factors (such as obesity, hypertension, diabetes) and sex-specific factors (such as menopause, pregnancy complications, autoimmune disease). The discussion delves into pathophysiologic mechanisms—visceral adiposity, inflammation, endothelial dysfunction—and emphasizes diagnostic challenges including subtle symptoms and lower natriuretic peptide levels due to hormonal effects. The guests advocate for early, holistic interventions spanning lifestyle modification, sleep apnea management, and newer therapies including sodium-glucose cotransporter-2  (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists. Overall, they stress a life-course, multidisciplinary approach tailored to women’s unique cardiovascular risks for improved prevention and outcomes.