Despite comprising over half of the heart failure population, women have been under-represented in most major clinical heart failure trials. Women with heart failure are more likely to have a preserved systolic function, be older compared to men, and are more likely to have hypertension, diabetes, and obesity as the etiology of their heart failure. Furthermore, overall survival is better for women. These factors suggest that the disease process in women is not entirely the same as in men, and perhaps should not be treated the same. However, given the lack of prospective large number trials looking specifically at women and heart failure, there have been no statistically significant data to support tailoring medical therapy differently between men and women.