We recently had a chance to learn more about sex and gender in cardiovascular research with Amy Johnston.
Johnston is looking at risk factors associated with disease. For example, how smoking can cause cardiovascular disease. In this case, they are looking at sex and gender in cardiovascular disease.
There seems to be an assumption that research performed in men can be transferred over to women, but in reality there are biological and physiological differences between the sexes that go beyond reproduction. This is important as cardiovascular disease is the leading cause of death of women worldwide.
Amy cautions that sex and gender are not the same and to be careful when using these terms. Sex refers to reproductive organs and chromosome assignment, while gender can be referred to as a “psychosocial sex”. It is a continuum and changes over time.
In previous research, there was an idea that the 70 kg male is representative of the species, but we now know that men and women differ in susceptibility to, risk for, many medical conditions, and they respond differently to medications. For example, smoking increases the risk of coronary heart disease in women more than men, and diabetes, high blood pressure, cholesterol and obesity increase the risk of cardiovascular disease in women to a greater extent than men. Johnston is particularly interested in women-specific cardiovascular risk factors, like pregnancy-related complications (i.e., high blood, gestational diabetes, etc.). Although 2 to 12% of pregnant women can have complications, data is not routinely collected when studying cardiovascular disease.
Many studies still do not report or discuss sex-based analyses (maybe because there aren’t enough female participants). Norris et al. (2020) have reported that women with cardiovascular disease in Canada are under-recognized, underdiagnosed, under-treated and under-supported.
Gender-related characteristics, roles and attitudes influence health differently than biological sex, as men and women may report gender-related characteristics traditionally attributed to the opposite sex.
There’s research currently being conducted in Montreal called GENESIS-PRAXY (Gender and sex determinants of cardiovascular disease: From bench to beyond-premature Acute Coronary Syndrome).
Johnston recommends the following for future cardiovascular disease research:
– Improve enrolment of women in trials (increase involvement in research)
– Report study outcome by sex
– Consider sex during all phases of drug development and gender in research and clinical practice
Want to learn more?
We encourage you to check out the website of the Canadian Institute of Health Research.