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Still Too Few Women in Heart Trials

Awareness of the unique challenges faced by women when it comes to heart disease prevention, diagnosis, and treatment has been increasing. However, research on strategies to prevent heart and blood vessel disease in women still lags behind that in men, according to a study published in the March issue of Circulation: Cardiovascular Quality & Outcomes.

What We Know

In recent years, it has become clear that heart disease often takes different forms in women and men. However, recommendations for life-saving treatments, diagnostic tests, and ways to prevent heart disease have traditionally been based on clinical trials conducted primarily in middle-aged men.

Since 1994, trials funded by the US government are required to contain women and to analyze results based on sex. However, it is not clear if these changes have translated into improved evidence about the best ways to prevent and treat heart disease in women.

What this Study Adds

This study examined whether current recommendations for preventing heart disease in women are based on research that was actually done in women, and if evidence in women has improved over time. The authors examined 156 research trials that were cited as evidence in the 2007 Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women. These guidelines are released by a group of medical associations (including the American Heart Association and the American College of Cardiology) to help doctors make decisions on the best way to prevent heart and blood vessel disease in their female patients.

The researchers found that, over time, representation of women in clinical trials of heart disease prevention has increased. In 1970, only 18% of participants were women, increasing to 34% in 2006. Despite these improvements, women continue to be underrepresented compared with men. Although half of all patients with coronary artery disease, heart failure, and high cholesterol are women, women only made up 25% to 30% of participants in trials of these conditions. Even when studies did include enough women, fewer than one in three analyzed the results separately in women.

What It Means For You

Although the past few decades have seen increasing involvement of women in clinical trials, women remain underrepresented in trials of strategies to prevent heart disease. Because of this, millions of women may be missing out on opportunities to reduce their risk for heart disease.

Growing awareness of the need to enroll more women in heart research should lead to continued improvements in the coming decades. The results of this study should also prompt doctors and researchers to study the reasons for the sex disparity, and to find ways to ensure equal representation for women.

On a personal level, you may want to consider joining a clinical trial and making a valuable contribution to the heart health of future generations of women. See Join a Clinical Trial for more about the risks and benefits of becoming a trial subject, and for links to resources that can help you find trials for which you are eligible.

Source: Melloni CM, Berger JS et al. Representation of women in randomized clinical trials of cardiovascular disease prevention. Circ Cardiovasc Qual Outcomes. 2010;3:135-142.

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