In 1912, a researcher described cardiovascular disease in men. It was not until 1928, however, that the same researcher wrote another paper showing women also suffered from the disease. This is one example of how research into and treatments for heart disease in women, the leading cause of death in women, has lagged for decades, a Feb. 1 Circulation Research article said.
The article, written by Natalie Bello, MD, director of hypertension research in the department of cardiology at the Los Angeles-based Smidt Heart Institute, and Susan Cheng, MD, the Erika J. Glazer Chair in Women's Cardiovascular Health and Population Science at the institute, summarizes a century-long history of cardiovascular care and research in women.
A "historically persistent slant" toward male-focused research, assumptions that most scientific findings in men would be generalizable to women, considering pregnant women to be a vulnerable population and a lack of diversity in research led to slow advances in women's heart health research. However, the article said changes in attitude toward research diversity have led to more opportunities and understanding.
"We now recognize that pregnant women are not necessarily vulnerable but are better described as a scientifically complex population," the authors wrote. "... Similarly, we are in the infancy of understanding sex-specific responses to therapies such as cardiac resynchronization therapy, angiotensin receptor neprilysin inhibitors and digoxin, to name a few."
The article recommends ways for medicine to continue to advance women's heart health research:
- Cultivate a diverse pipeline inclusive of individuals of all sexes and genders, as well as races.
- Clinical trials should assess for sex-specific differences. It is not sufficient to prespecify sex as a subgroup of interest.
- Researchers cannot make observations about variables they do not measure, and all human studies of any design must obtain reproductive history for all participants.
"Looking ahead to the future of cardiovascular health of women, challenges remain, but emerging opportunities hold great promise to advance the field," the authors wrote. "Similarly, the incorporation of a more diverse set of stakeholders from the outset of clinical trials will also hopefully lead to a more comprehensive acquisition of female-specific health data and information that can uncover more about the risk factors and treatment approaches that may more specifically benefit women."