Santema BT, Ouwerkerk W, Tromp J, et al. – Researchers performed a post hoc analysis of BIOSTAT-CHF to determine whether there exists gender disparities in the optimal dose of angiotensin-converting-enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) and β blockers in patients with heart failure with reduced ejection fraction (HFrEF). Excluding the patients who died within the first 3 months, eligible study participants included patients with left ventricular ejection fraction < 40%. A composite of time to all-cause death or hospitalization for heart failure was assessed as the primary outcome. The investigators used an independent cohort, ASIAN-HF, which included 3,539 men and 961 women with HFrEF, to validate the findings. The occurrence of lowest hazards of death or hospitalization for heart failure in men was noted at 100% of the recommended dose of ACE inhibitors or ARBs and β blockers, but nearly 30% lower risk was observed in women at only 50% of the recommended doses, with no further reduction in risk at higher dose levels. According to the findings, women with HFrEF vs men might require lower doses of ACE inhibitors or ARBs and β blockers. The findings bring into question what the true optimal medical treatment is for women vs men.