Women with heart failure achieve significantly better outcomes from half the recommended dose of ACE inhibitors, angiotensin-receptor blockers and beta blockers than men, a Dutch-led study suggests.

The landmark findings, published in the Lancet, challenge the conventional ‘one-size-fits-all’ approach to treating heart failure and could have important implications for sex-specific target doses, the researchers say.

They analysed data from a prospective European study of 1720 patients (24% women) with chronic heart failure with reduced ejection fraction (HFrEF) who were encouraged to initiate or uptitrate ACE inhibitors or ARBs and beta blockers in the first three months of the study period.

The women in the cohort were older (mean age 74) and had lower bodyweights and heights than their male counterparts (mean age 70).