Cardiovascular disease remains the leading cause of death for women globally, yet significant progress in prevention, diagnosis and management has been made through increased sex-specific research, according to a special Go Red for Women issue of Circulation. The issue confirms the journal's dedication to advancing women's cardiovascular health by showcasing new research about cardiovascular disease in women, with nearly 45% of women older than 20 living with some form of cardiovascular disease according to the American Heart Association's 2026 Heart Disease and Stroke Statistics.
A new American Heart Association scientific statement focused on acute coronary syndromes in premenopausal women, published in this special issue, reveals that women often face delayed diagnosis and atypical symptom recognition resulting in worse outcomes compared to men. The statement details how women frequently misattribute cardiac symptoms to less serious causes and are less likely to be immediately triaged in emergency departments when presenting with cardiac symptoms, making them particularly vulnerable to missed heart attacks. The statement encourages improved clinical awareness, tailored diagnostic strategies and greater representation of women in research to address these gaps.
Dr. Stacey Rosen, volunteer president of the American Heart Association, acknowledges the longstanding gap in women's cardiovascular care that has led to missed insights into how heart disease affects women. In her article featured in the special issue, she urges clinicians, health care professionals and researchers to understand the role that sex plays in cardiovascular health and disease. She writes that improving cardiovascular health for women requires going beyond being an ally to becoming an advocate in integrating sex as a biological variable as a foundational pillar in improving health outcomes.
Several studies in the special issue examine specific conditions during pregnancy that impact mothers and their babies, including hypertensive disorders of pregnancy, discontinuing statin use before pregnancy, and the impact of maternal smoking during pregnancy on childhood blood pressure. Research also explores how preexisting conditions such as polycystic ovarian syndrome are associated with various cardiovascular conditions. Additional studies address opportunities to increase women's design of and leadership in clinical trials, with researchers advocating for initiatives that advance participation of women investigators in clinical research given that less than 40% of all research trial participants are women according to data available at https://www.heart.org/en/news/2024/02/01/women-underrepresented-in-clinical-trials.
Researchers also presented ways to leverage artificial intelligence to improve understanding of cardiovascular disease risk in women and to enhance abilities to recruit women to participate in trials. The American Heart Association launched Go Red for Women in 2004 to better understand women's cardiovascular health and address gaps in care, with funds raised dedicated to research, awareness and education about women's heart health that have supported more than 200,000 health care professionals with educational tools. The full manuscripts from the special issue can be viewed at https://www.ahajournals.org/toc/circ/149/5, providing comprehensive research on these critical topics in women's cardiovascular health.
