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While monogenic forms exist—typically rare, early-onset, and associated with high penetrance—late-onset familial cases often display incomplete penetrance, with carriers remaining asymptomatic until midlife or after hormonal transitions such as menopause and andropause (Breeze et al., 2024

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Notably, the EMPEROR-Preserved trial demonstrated that empagliflozin significantly reduced cardiovascular mortality and hospitalization in HFpEF patients without increasing adverse events