Cardiovascular disease is the leading cause of death for American women, yet they continue to be underrepresented in clinical research related to the condition.
Just 25% of participants in heart attack trials are women. That number jumps to 40% for stroke research. But it’s still not enough. The resulting gaps in medical knowledge from underrepresentation of women skew the effectiveness of cardiovascular care and lead to worse treatment outcomes for women.
President Joe Biden, in March, signed an executive order and announced more than 20 new actions to “expand and improve research on women’s health.” These efforts, alongside the first-ever White House Initiative on Women’s Health Research, aim to “fundamentally change” the nation’s current approach to women’s health research.
Women Were Excluded from Foundational Research
Heart disease was long believed to impact men more than women, at least until women reached menopause. In many cases, doctors didn’t look for it in women, and researchers didn’t investigate it.
In fact, women were not widely included in clinical trials until the 1990s. To this day, ongoing challenges to women’s participation center around recruitment. Fewer women are treated for heart disease, fewer women are referred to researchers by their doctors, and fewer women may be able to participate due to family or childcare obligations – a burden unevenly borne by women.
Women Face Unique CVD Risks
Even as the understanding and treatment of cardiovascular disease has improved, women under 65 continue to die twice as often after a heart attack as their male counterparts, for whom many screenings were initially designed and on whom interventions were tested.
Symptoms of heart disease often present differently in men and women. And women’s hearts experience different risk factors than men’s do. For example, cardiovascular health can be particularly challenged by pregnancy and childbirth, as evidenced by the fact that cardiovascular disease is the leading cause of death in expectant and new moms. Oral contraceptive use, perimenopausal hormone supplements and treatments for female reproductive cancers are all associated with increased cardiovascular risks, too.
Despite these increased risk factors, women are less likely to undergo proactive heart health screenings. Sadly, many cardiologists report they are ill-equipped to identify or assess heart disease risks specific to women.
Until women’s heart research and treatment reach parity with men’s, women will continue to receive subpar care and experience unnecessary mortality from heart disease.
