Beale AL, et al. - Researchers investigated the sex differences in vascular and ventricular structure and function as well as the impact on the primary outcome in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial). According to sex and achievement of the primary end point (a composite of death from cardiovascular causes and heart failure hospitalization), a comparison of patients with echocardiography (n=654) was done. Women vs men had greater arterial and ventricular elastance and worse ventricular-vascular coupling. Outcomes revealed that, compared to men with heart failure with preserved ejection fraction (HFpEF), women with HFpEF had better overall survival. However, differences were noted in the factors affecting hospitalization and survival in HFpEF between the sexes; pulse pressure is an important in determining outcome in women, while heart rate and B-type natriuretic peptide are significant in men. This indicates key sex differences in the pathophysiology and outcomes of heart failure with preserved ejection fraction and justifies further exploration.