Closing the Gap: Examining Representation of Women in Ischemic Heart Disease Guideline Studies
Recommended Citation
Abdelnour J, Alameh A, Anaya F, Driscoll K, Abdelnour N, Sukhon F, Jabri A, Alhuneafat L, Yaghmour R, Alqarqaz M, Aggarwal V, Abbas AE, Nandar PP, Siraj A, Gulati M. Closing the Gap: Examining Representation of Women in Ischemic Heart Disease Guideline Studies. J Am Heart Assoc. 2026;15(10):e038120.
Document Type
Article
Publication Date
5-19-2026
Publication Title
J Am Heart Assoc
Keywords
Humans, Female, Myocardial Ischemia, Practice Guidelines as Topic, United States, Healthcare Disparities, Clinical Trials as Topic, Sex Factors
Abstract
BACKGROUND: This study aimed to evaluate the representation of women in cardiovascular clinical trials referenced in the American College of Cardiology and American Heart Association guidelines, given the historical underrepresentation of women in such trials, which limits generalizability and perpetuates health care disparities.
METHODS: We conducted a systematic review of studies referenced in American College of Cardiology and American Heart Association guidelines for chronic coronary artery disease, chest pain, and coronary artery revascularization. Data extraction focused on study type, publication year, total study population, and proportion of women enrolled. Participation-to-prevalence ratios were calculated to assess gender representation relative to disease prevalence among women in the United States.
RESULTS: Our systematic review encompassed 1690 studies revealing persistent underrepresentation of women across all guideline areas: revascularization (29.5%), chronic coronary artery disease (33.3%), and chest pain (40%). Participation-to-prevalence ratios ranged from 68.2% to 83.2%, indicating substantial gaps in representation compared with disease burden. Trends over 4 decades showed variability in women's inclusion, with some improvement but minimal overall progress.
CONCLUSION: Despite increased awareness and advocacy, our findings highlight ongoing gender disparities in cardiovascular research. Proactive strategies are needed to enhance women's participation in clinical trials, ensuring equitable and effective health care interventions. Addressing these disparities is critical for developing tailored treatments and improving cardiovascular outcomes globally. Future research should prioritize identifying and overcoming barriers to women's enrollment in cardiovascular trials to promote inclusive clinical practice and mitigate health care disparities.
Medical Subject Headings
Humans; Female; Myocardial Ischemia; Practice Guidelines as Topic; United States; Healthcare Disparities; Clinical Trials as Topic; Sex Factors
PubMed ID
42132162
Volume
15
Issue
10
First Page
038120
Last Page
038120
