Breaking Female Hearts: The Gender Gap in Cardiovascular Research

Abstract

Cardiovascular disease is the biggest killer of both men and women, causing 17.5 million deaths
combined in 2012,1 which is expected to rise to 23.4 million by 2030.2 The leading cause of
death in both sexes is ischemic heart disease, with hypertensive heart disease also appearing in
the top ten and vascular complications the majority of the remainder.1 Notably, mortality rates
are increasing more rapidly in younger women compared to men.3 Given these observations, it
might be expected that our knowledge of the cardiovascular system and treatment of its disorders
would be based on studies performed on biological material and organisms of both male
and female origin, in fairly equal proportions. However, this is simply not the case. In biomedical
research, many publications do not specify the sex of the animals (presumably the reader
should assume male), and where sex is specified the majority focus on males.4 In addition,
drug studies are conducted mainly on males.5 Equal representation of men and women is also
lacking in many large-scale clinical trials4,6; somewhat surprising given that women represent a
rather significant proportion of patients undergoing treatment in the clinic.