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Apr 01, 2011

Women Underrepresented in Cardiovascular Research: A Call for Change

More women need to be included in studies to learn about prevention of heart disease.

We’ve all seen it in the tv, movies, and media – an alarming image of a middle-aged man clutching tightly to his chest, suffering from a heart attack. While this scenario perfectly illustrates the longstanding belief that heart disease primarily affects men, current research has proven that this couldn’t be farther from the truth. Data has shown that not only do women suffer from cardiovascular disease, cardiovascular conditions can be more serious and cause different symptoms in females than males.

Accordingly, a recent study published in the March 15th, 2011 issue of the European Heart Journal titled Red Alert for women’s heart: the urgent need for more research and knowledge on cardiovascular disease stressed the need for additional cardiovascular research in women, as the majority of cardiovascular research in the past has involved male participants. While female participation has slightly increased over the years, they remain vastly underrepresented, accounting for less then one-third of participants in cardiovascular clinical trials since 2006. This disparity may not seem like a big concern, but implications are huge.

The prevention and treatment of cardiovascular disease in women is based primarily on research that was conducted in men, under the assumption that cardiovascular disease is similar in both genders. However, research continues to demonstrate vast cardiovascular differences in men and women, highlighting the need for rigorous gender-specific research in the coming years to help tailor more detailed cardiovascular guidelines for women.

Also, as a result of the previous focus on the prevention of cardiovascular disease in men, research has helped to decrease the prevalence of heart disease in men while overlooking the increased burden of this disease in women. Since 1990, the number of middle-aged men (ages 35-54) suffering heart attacks has decreased, yet the number of similarly aged women has increased. Worldwide, cardiovascular disease is the number one cause of disability-adjusted life years (DALYs) lost in women over 45, causing more years lost to cardiovascular disease at older age than men. Furthermore, mutual risk factors such as smoking, high blood pressure and diabetes can have more serious cardiovascular implications in women than in men, not to mention the gender-specific issues (i.e. pregnancy and hormonal changes) that further increase their risk for heart disease.

With the burden of cardiovascular disease continually increasing in women, additional cardiovascular research is urgently needed among this population. Until more is known about cardiovascular disease in women, it cannot be effectively addressed and this highly preventable disease will remain the number one killer of women nationwide.

Questions for You to Consider

  • Why are women underrepresented in cardiovascular research studies?
  • Since cardiovascular disease was originally thought to be more prevalent in men, most research targeted men as participants. Even now that research has shown that heart disease is not only the number one killer of women and men, and that it actually kills more women each year than men nationwide, many women do not know this. Therefore, the lack of female participation in cardiovascular studies may be largely due to the lack of awareness.  It is also believed that many women, juggling their many responsibilities in life, are often so concerned with taking care of others that they fail to take the time to address their own health needs.
  • What are significant differences in the cardiovascular health of women vs. men?

  • While additional research is needed further understand the cardiovascular differences between men and women, one significant variation is among heart attack symptoms. For men, the most common sign of a heart attack is pain or pressure in the chest. Women, on the other hand, are more likely than men to have unusual or "atypical" signs of a heart attack, and some of these symptoms may come and go. The danger is that many women are unaware of these differences in symptoms, and will often disregard a heart attack for fatigue or the flu. There are additional recognized differences between men and women, including the time at which the disease sets in, severity of shared risk factors and the presence of unique risk factors associated with hormonal changes and pregnancy.
  • Are men no longer at significant risk for heart disease?

  • Cardiovascular disease remains the number one killer of both men and women in the United States, so it is just as important that men maintain their cardiovascular health as much as women. However, more is known about cardiovascular disease in men, which increases the ability to effectively prevent and manage heart disease in the population. Men are also more aware of their risk for heart disease than women, so they do not require the additional attention that women currently need surrounding cardiovascular disease.


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