Sex/Gender Differences in Cardiovascular Disease Prevention

Abstract

Over the past decade, scientists, healthcare providers, the public, and policy makers have made substantial efforts to improve understanding of the sex/gender*differences in cardiovascular disease (CVD)†and to recognize the importance of heart disease in women. Federal and American Heart Association (AHA) initiatives to raise awareness and to reduce gender disparities in research and clinical care are listed in Table 1. There was a near doubling of the rate of awareness of heart disease as the leading cause of death in women between 1997, when the AHA launched its first campaign for women, and 2009; during that same period, the death rate resulting from CVD decreased by nearly half.2–4 The extent to which efforts to close research gaps and to heighten awareness of heart disease in women are causally linked to lower CVD mortality or have resulted in improved clinical outcomes for women is not established. The purposes of this article are to evaluate contemporary sex/gender differences in the burden of CVD, to assess the impact of recent clinical trials on recommendations for the prevention of CVD in women, and to examine factors that may facilitate or impede quality CVD preventive care in women. Recommendations for the design and analyses of future CVD clinical trials in women are also provided. View this table: Table 1. Initiatives Affecting Women and Cardiovascular Disease Although CVD remains the leading killer of both women and men in the United States, there are substantial sex/gender differences in the prevalence and burden of different CVDs, as outlined in Table 2. For both women and men, coronary heart disease (CHD) is the largest contributor to CVD morbidity and mortality. The absolute numbers of women living with and dying of CVD and stroke exceed those of men, as does the number of hospital discharges for …