At a glance
- Cardiovascular disease (CVD) is the leading cause of death for women. Cardiovascular conditions in the United States make up at least a third of the women’s health gap because of inequities between women and men in care delivery, efficacy, and data availability.
- Addressing heart health at every life stage can improve a woman’s quality of life and overall health. It could lead to at least 1.6 million years of higher-quality life and boost the US economy by $28 billion annually by 2040.
- In the United States, Black women have a higher prevalence of and morbidity from CVD than non-Black women do.
In the United States, cardiovascular disease (CVD) is the leading cause of death for women. Today, more than 60 million women are living with CVD.1 They’re more likely than men to die from a heart attack and to develop heart failure in the five years after discharge from the hospital.2
CVD makes up over a third of the health gap between US men and women, as measured in potential years of healthy life (Exhibit 1). Analysts have quantified this gap in terms of disability-adjusted life years. Building on previous research from the McKinsey Health Institute and the World Economic Forum on the women’s health gap,3 additional insights have found that the United States has the potential to gain an additional $28 billion in GDP by 2040 by closing the gap in heart health between men and women.4
Women constitute half of the population, workforce, and community and are responsible for over 80 percent of a family’s medical decision making. Therefore, their well-being plays a pivotal role in shaping the overall health of families and communities. Enabling women to be healthier sets in motion a ripple effect of positive cardiovascular-health choices in the public, private, and social sectors that can lead to a healthier population, including for caregivers.5
Addressing women’s heart health and reducing CVD risk factors also has potential financial benefits for employers. One study estimated that the per-year price of employee absenteeism costs a large employer from around $17,000 for diabetes to more than $285,000 for physical inactivity.6
CVD presents differently in women and men. Yet a pervasive one-size-fits-all mentality for it remains throughout the healthcare delivery ecosystem. Research revealed that only 22 percent of physicians and 42 percent of cardiologists felt extremely well prepared to adequately assess CVD specific to women.7
Caring for heart health should be a priority throughout a woman’s lifespan, not just at older ages when acute symptoms are most prevalent and most expected by women themselves. It’s possible to address modifiable risk factors and focus on prevention before CVD sets in. For example, four out of five maternal deaths are preventable. Considering that CVD remains the leading cause of maternal deaths, this overlap indicates that addressing prevention can lower maternal mortality related to CVD.8 The women’s heart health gap in the United States is addressable by providing sex- and gender-appropriate cardiac care and research. This can be supported by investments, innovation, education, and public-awareness campaigns.
By addressing the CVD gap between men and women in the United States, women could live longer and higher-quality lives, potentially regaining 1.6 million years of life lost because of poor health and early deaths.9
Women are biologically different from men
A woman’s cardiovascular health is influenced by biological factors that are rooted in unique life stages. Women and men share many traditional risk factors for the development of CVD, such as obesity, smoking, and diabetes. But the relative impact of these may vary because of biological differences and behavioral practices. For example, literature suggests that although men have a higher prevalence of diabetes than women do, the presence of diabetes increases cardiovascular risk by three- to sevenfold in women, compared with a two- to threefold increase in men.10 Men have a higher prevalence of CVD, but women are more likely to die after having an acute cardiovascular event.11
Estrogen, a sex hormone, is believed to have a protective effect on the heart and may potentially explain some of the differences. Estrogen plays a role in regulating various metabolic functions, such as lipid levels (amounts of fat) in the blood, inflammatory markers (contributing to damage to vessel walls), and the coagulant system (affecting blood clot formation).12 Additionally, estrogen is believed to help relax and open up blood vessels throughout the body, allowing for better blood flow.
The understanding of biological differences such as these has expanded, but major knowledge gaps still exist. Heart health—or lack thereof—affects not only the cardiovascular system but the whole body, including the gastrointestinal, immune, musculoskeletal, neurological, pulmonary, and renal systems. For example, midlife hypertension is associated with an approximately 60 percent increased risk of all-cause dementia, and systolic hypertension (systolic blood pressure greater than 160 millimeters of mercury) is associated with an approximately 25 percent increased risk of Alzheimer’s disease.13
By 2040, brain health and heart health together could contribute to nearly half of the US women’s health burden gap (or two million years of life lost each year because of poor health or early death).14 Improving brain health and heart health together could add over $100 billion in annual US GDP by 2040. Addressing CVD throughout a woman’s lifespan can have enormous benefits in both cardiovascular health and quality of life at large.
Women go through unique stages of life characterized by fluctuating levels of estrogen (such as puberty and menopause) and additional physiological stress on the body (such as pregnancy). With the increasing prevalence of CVD in women, novel sex-related risk factors should be considered in combination with behavioral, environmental, and social factors to guide its early prevention, diagnosis, and treatment in women across all stages of life (Exhibit 2).
Adolescence and puberty mark the first changes
A woman’s first menstrual period (menarche) usually occurs between the ages of 10 and 16, after a yearlong rise in daily estrogen output.15 Menstrual cycles have been shown to have an impact on a woman’s CVD risk later in life.
For one, the age of menarche may play a role in CVD risk. A study found that those who had menarche earlier than the age of 12 had an increased risk of CVD and of some of its associated risk factors, such as metabolic syndrome, obesity, and diabetes. The mechanisms linking early menarche and CVD aren’t fully understood but may be explained in part by genetic and lifestyle factors, such as reduced physical activity and excess calorie consumption.16
There’s an association between irregular menstrual cycles (affecting around 20 percent of women) and elevated body mass index, total cholesterol, and triglycerides, which may increase the overall risk of CVD. Irregular menstrual cycles also independently contribute to the increased risk of CVD.17 Potential mechanisms by which irregular or prolonged menstrual cycles affect cardiovascular health include decreased estrogen exposure and shared risk factors, such as obesity.
There’s ample opportunity for research into better understanding the links between menstruation and the overall health of a woman. With greater knowledge and treatment options, women can embark on a lifelong journey to view their heart health more holistically.
Pregnancy and childbirth can strain a woman’s heart
Pregnancy puts a physiological strain on a woman’s body, including on her heart. As early as eight weeks into pregnancy, a woman’s body experiences multiple changes, including increased blood volume and increased cardiac output.18 Beyond normal physiological changes during pregnancy, a number of pregnancy-specific conditions have been associated with adverse cardiovascular outcomes.
The US Centers for Disease Control and Prevention found that four out of five maternal deaths in the United States are preventable. The leading cause of these deaths are CVD (cardiac and coronary conditions) (13 percent), thrombotic embolism (9 percent), cardiomyopathy (9 percent) and hypertensive disorders in pregnancy (HDPs) (7 percent).19 More than half of pregnancy-related deaths occur in the year after childbirth. Yet up to 40 percent of women don’t access postpartum care, and only an estimated 18 to 25 percent of postpartum patients with pregnancy complications are seen by a primary care provider (PCP) within six months of delivery.20
Physicians and patients alike must be taught to recognize these issues. Helping pregnant women holistically, beyond reproductive care, creates a vast opportunity to reduce adverse outcomes for mothers and babies. It may also reduce modifiable risk factors for CVD before it’s too late.
Pregnancy-related hypertensive disorders
HDPs affect up to 10 percent of pregnant women in the US and are the cause of 7 percent of maternal deaths.21 HDPs include gestational hypertension (new-onset hypertension of 140 over 90 millimeters of mercury after 20 weeks’ gestation in a previously normotensive woman), chronic hypertension (hypertension before 20 weeks’ gestation), and preeclampsia. Women who develop HDPs in their first pregnancy are at an increased risk of recurrence in subsequent pregnancies. They are also at a higher risk of developing hypertension, stroke, and ischemic heart disease in later life.22
Preeclampsia is a pregnancy-specific condition characterized by hypertension after 20 weeks of gestation and the presence of proteinuria (protein in the urine) and/or end-organ dysfunction.23 The mechanism of preeclampsia isn’t fully understood, and the only definitive cure for the condition is the delivery of the fetus and the placenta.24
Women with preeclampsia have a fourfold relative risk of developing hypertension later in life, a twofold risk for ischemic heart disease, a twofold relative risk of stroke, and a twofold relative risk for venous thromboembolism (Exhibit 3).25 Furthermore, the severity of preeclampsia and its earlier onset are correlated with the severity of CVD later in life.
Gestational diabetes
Gestational diabetes is a pregnancy-specific condition defined as newly diagnosed diabetes mellitus beyond the first trimester of pregnancy. This condition affects up to 14 percent of pregnancies around the world.26 Gestational diabetes not only increases the risk of developing type 2 diabetes by sevenfold but also independently raises CVD risk (twofold for stroke and fourfold for myocardial infarction) later in life.27
Peripartum cardiomyopathy
Peripartum cardiomyopathy is a pregnancy-specific condition without a reversible cause. It presents near the end of pregnancy or in the postpartum period in a woman without known heart disease.28 Although relatively rare (incidence of one in 1,000 to 4,000 US live births), it can carry a high mortality of up to 11 percent in the United States, as shown in a longer-term follow-up study of patients in Midwestern academic centers.29
Menopause symptoms may play a role in hypertension
Menopause is a natural part of a woman’s biological aging characterized by the end of the menstrual cycle and reduced estrogen and progesterone. It typically occurs between the ages of 45 and 55. CVD is more common in postmenopausal women than in similarly aged men, though this isn’t the case prior to menopause.30 Women between the ages of 45 and 65 (around menopausal transition) have the greatest rise in the prevalence of hypertension, yet more research is needed to understand why.31
Up to 80 percent of women may experience common menopausal symptoms, such as hot flashes and night sweats. These vasomotor symptoms (VMS) may play a role in hypertension and increased CVD risk. A study showed that women with frequent VMS associated with menopause had a 77 percent higher risk of developing CVD than did women with no or less-frequent VMS.32
CVD disproportionately affects women of color
When examining women’s cardiovascular health, statistics show how race and ethnicity can also affect women’s healthcare experience. From initial diagnosis to treatment outcomes, women of color often face disparities in care. While some progress has been made, substantial opportunities to address these inequities remain.
In the United States, 59 percent of Black women over the age of 20 have some form of CVD, compared with 43 percent of Hispanic American women, 43 percent of Asian American women, and 42 percent of White women (Exhibit 4).33 American Indian and Native Alaskan women have a prevalence of type 2 diabetes—up to 72 percent in some communities—that’s three times higher than that of White American women.34
Despite having a high prevalence of CVD, persons of African, Hispanic, or Indigenous descent are underrepresented and underreported in US clinical trials.35 Women of color sit at the intersection of both low representation of women and low representation of non-White races and ethnicities in clinical trials, making their representation in clinical trials even more pertinent.
Black women are at a significantly higher risk than White women of developing CVD during pregnancy, having preterm deliveries, and delivering low-birth-weight infants, and they have the highest postpartum CVD risk, even when adjusted for socioeconomic status.36 In the United States, the incidence of preeclampsia is 60 percent higher in Black women than in White women.37 Additionally, Black women face more adverse outcomes related to the condition, including kidney damage and mortality.38 American Indian and Native Alaskan women have the highest mortality from peripartum cardiomyopathy (14.5 percent) out of all US ethnic and race groups.
The reasons for these discrepancies are multifactorial and include structural inequalities and health-related social needs. Addressing biases, providing differential training for those serving these communities, and offering tailored healthcare delivery models that address specific communities would create more equity in care delivery for women of color.
Cardiovascular research often underrepresents women, resulting in subpar treatment outcomes
Basic research, including in animal models, often excludes female subjects. One examined compilation of studies published from 2006 to 2016 that focused on preclinical cardiovascular research discovered that the sex of the animals used wasn’t disclosed in 20 percent of the studies.39 Among the studies that did report the sex, only males were used in 72 percent of cases, only females were used in 13 percent of cases, and both sexes were used in 16 percent of cases. Many researchers believe that including females may hamper studies because of the need for larger sample sizes, the increased cost, and the higher variability of female data as a result of the estrous cycle.40
Sex should be a consideration as part of initial study design, not only as an afterthought when outcomes differ. For example, between 1997 and 2000, the US Food and Drug Administration removed ten drugs from the market because of adverse events, with one drug noted to have a specific cardiovascular intervention.41 Eight of those drugs posed greater risks to women than to men, and six correlated with comparatively poorer cardiovascular outcomes in women.
Despite US Congress passing a law in 1993 that required the inclusion of women in clinical research, a gender gap remains. A study looking at 740 trials in cardiovascular health from 2010 to 2017 found that women made up only 38 percent of study participants.42 Even after adjusting for prevalence, women were underrepresented in trials related to acute coronary syndrome (ACS), coronary heart disease, and heart failure. Additionally, although postmenopausal women are often the ones most affected by CVD, they also had the lowest study participation rates (26 percent).43 A smaller study, looking at 263 studies as recent as 2016 to 2019, found that women were in slightly less than 42 percent of cardiovascular studies, although 49 percent of the female population had CVD.44
The reasons for this are multifactorial, spanning systemic barriers, inadequate trial design, and participant-specific barriers. First and foremost, women need to be asked to participate as routine. Trials need to reflect geographies where a diverse population of women reside or offer alternative means of participation, such as digital engagement.
Furthermore, women often must juggle wage earning with more caretaking responsibilities than men have. Therefore, it’s important to focus on finding ways to lessen the burden of clinical trial participation and address the challenges. Examples include providing assistance for aspects such as travel, transportation, food, eldercare, childcare, and other related expenses if visits to the trial sites are necessary and advancing the acceptability and ease of distributed clinical trials.45
Without enough women participating in trials, researchers have limited data on how treatments and preventative measures affect the female body, especially during transitions that include puberty, pregnancy, and menopause. Consequently, treatment recommendations may not be optimized for women, potentially leading to misdiagnosis and inadequate care.
For example, troponin tests, the gold standard of blood testing for the diagnosis of ACS (conditions characterized by sudden reduced blood supply to the heart), may be underdiagnosing women. Research has demonstrated the upper limits of normal may be twofold higher in men than in women; however, lab standards are based on men, resulting in underdiagnosis of women.46 One study showed that using sex-differentiated troponin levels in testing increased ACS diagnosis in women by 42 percent and 6 percent in men.47
When looking at common interventions for heart failure, women may experience greater risk, side effects, and even worse outcomes than men do. This finding could be the result of a variety of factors, from differences in body composition to drug metabolism to hormone level fluctuations.48 One study found that standard dosing of common cardiac medications (for example, ACE inhibitors, angiotensin receptor blockers, and beta-blockers) resulted in increased drug effect in women than in men at the same dosage, with a higher frequency of side effects.49
Women miss out on sex-appropriate cardiac care because of care delivery gaps
A lack of knowledge, limited availability of sex- and gender-specific medical education, and various implicit and explicit biases contribute to the inequity in CVD care delivery.
The lack of knowledge persists throughout medical training. One study showed that only 22 percent of PCPs and 42 percent of cardiologists felt extremely well prepared to assess CVD risk in women.50 Indeed, in one survey of over 40 medical schools in Canada and the United States, 70 percent of respondents didn’t formally include sex- or gender-specific content in their curriculum.51 With many women relying on an ob-gyn as their PCP, sex- and gender-specific cardiovascular training should expand beyond traditional primary care and cardiology training.52
Current risk formulas often overlook factors that influence women’s CVD risk—especially those related to menstrual cycles, pregnancy, and menopause (Exhibit 5). Additionally, research suggests that including health-related social needs (such as economic stability, neighborhood safety, and access to quality healthcare) in risk assessments for women, particularly women of color, can provide a more comprehensive picture of CVD risk.53
Previous research has examined gender disparity in cardiac treatment, particularly in relation to ACS. ACS presentation in men and women often differs. While chest pain is still the most common presentation in both sexes, women often report additional symptoms, such as abdominal pain, jaw pain, nausea, shortness of breath, palpitations, and vomiting.54 In one study, upon presentation to the hospital with chest pain, women were more likely than men to attribute their symptoms to stress or anxiety (20.9 percent versus 11.8 percent). This may result in diagnostic inaccuracies and delayed treatment.
Furthermore, nonspecific electrocardiogram (EKG) changes are more common in women than in men—for example, estrogen-associated EKG changes mimicking ischemia.55 This may be exacerbated by incorrect placement of the EKG electrodes because of presumed signal reduction by breast tissue.56 It can potentially be mitigated by ensuring correct positioning using bone landmarks. This can help minimize inaccuracies in the EKG and prevent misdiagnosis.57
Women continue to have worse outcomes after ACS compared with men.58 They’re less likely to undergo coronary revascularization and receive essential ACS treatment at admission or discharge, even when adjusted for demographics, patient characteristics, and type of hospital. Women were 2.5 times less likely than men to be referred to a cardiologist after initial presentation with chest pain in an ambulatory care setting, particularly when the initial diagnosis was undertaken by a male physician.59 In addition, women treated by female physicians may have a better chance of surviving a heart attack.60
Similarly, a study has shown that women were less likely than men to receive more aggressive (and appropriate) risk-factor-modification treatment (for example, statins), particularly when they were treated by a male PCP.61 A large Canadian study focusing on atrial fibrillation found that male physicians were more likely to overestimate the risk of stroke in men but underestimate it in women.62 In contrast, female physicians could accurately estimate the risk in women but underestimate it in men.
It’s worth noting that even though half of medical-school graduates are women, women currently make up only 15 percent of adult cardiologists and 4 percent of interventional cardiologists in the United States.63 Research conducted by the American College of Cardiology reported that almost two-thirds of female cardiologists consistently experienced discrimination at work, mostly related to gender and childbirth.64 Less than a quarter of men reported discrimination, which was largely in relation to race and religion rather than gender.
A survey of internal medicine trainees found that having a positive role model was the most important professional development need for both men and women.65 A significant majority of women felt that the field of cardiology lacked the positive role models they were looking for. This lack of role models, combined with discrimination, may discourage potential candidates from entering the field and perpetuate low rates of women serving as mentors for future trainees.
These biases extend beyond the clinical setting. Women are less likely than men to receive bystander cardiopulmonary resuscitation in case of out-of-hospital cardiac arrest, resulting in lower survival to discharge (the odds ratio for men to women is 1.27). 66
The use of AI in healthcare has seen a dramatic increase in recent years. Some uses show great promise. In one study, clinical-decision-making accuracy in chest pain evaluation was improved with the assistance of AI, without introducing or exacerbating existing gender biases.67 Amid busy schedules, clinicians often don’t have the time to stay on top of the latest research and clinical guidelines, so using AI tools as prompts to ask pertinent questions in a consultation (for example, assessing a woman’s menopausal history as part of a comprehensive CVD risk assessment) could be a viable solution.
However, machine learning models that are trained on data sets containing primarily men can result in suboptimal results, mistakes, and discriminatory outcomes, because they do not consider the sex and gender differences in health and disease.68
Innovation and investment in women’s heart health could make a difference
All ecosystem stakeholders could play a role in integrating a sex-specific lens at the onset of trial design, incorporating it into innovation design, testing, and launch. To continue discovering the most effective CVD prevention methods and interventions for women, greater investment in both women’s heart health and heart health overall is needed. CVD research funding made up less than 6 percent of the US National Institutes of Health (NIH) budget in 2022, with only a fifth of that dedicated to women’s heart health.69 That category includes, for example, conditions that may be unique to women or more prevalent in women than in men for which medical interventions may be different or there has been insufficient clinical data on women.
Women primarily drive 80 percent of healthcare decisions and spending for their families.70 However, investments continue deprioritizing sex-specific care. As biopharma companies are exploring new mechanisms of action for novel cardiovascular therapies, they can be leaders in developing sex-specific strategies, from R&D to commercialization. For example, they can aim to understand the biological impacts on women of drug metabolism, pharmacodynamics, and pharmacokinetics. Biopharma companies can also embrace a strategy for women’s heart health that extends beyond the cardiovascular system. This would require acknowledging the overlap between therapeutic areas and cross-therapeutic area expansion (for example, into cardiovascular, metabolic, renal, and other areas).
In addition to expanding sex-segregated R&D across emerging clinical interventions that benefit both women and men, increased investment is needed for female-specific heart health conditions (for example, preeclampsia). In 2020, only 1 percent of healthcare research and innovation was invested in female-specific conditions beyond oncology.71
Venture capital investment in women’s health has increased 314 percent over the past five years; however, investment in FemTech (diagnostic tools, products, services, wearables, and software that use technology to address women’s health issues) makes up 2 percent of the overall health sector.72 Women make up 13 percent of start-up founders overall yet were 24 percent of FemTech founders in 2022—a rate that declined to 22 percent in 2023.73 Since women only receive 2 percent of total venture capital funding in the United States,74 this puts FemTech at a potentially greater disadvantage.
In parallel, research suggests that cardiovascular-health-related start-ups and innovations receive less funding than other major therapeutic areas do.75 And when they do receive funding, it’s mostly in digital health or data-driven business models, suggesting that start-ups with a cardiovascular focus outside of these fields may continue to be underfunded.76
Female leadership across healthcare research and delivery matters. While women make up the vast majority of the US healthcare workforce, only about a third of US hospitals are led by women, and less than 15 percent of system CEO roles are filled by women.77 A study across 4,271 medical products demonstrated that boards with women participating as directors announced recalls about four weeks earlier than boards with all men did.78 With a lower number of women in decision-making positions, there might be a blind spot regarding the potential and importance of women’s health innovations, especially in conditions such as CVD that have been primarily associated with men.
As a note, the investment landscape for FemTech is still nascent, with most companies in that field focused on maternal health, menstrual health, and fertility. Although there’s a growing opportunity to address women’s health beyond female-specific conditions, such as in cardiovascular health, fewer than 20 early-stage companies focus on women’s cardiac health—and the majority of those focus on maternal cardiac health.79 While FemTech funding has continued to increase, there’s still a lag in funding for women’s cardiovascular health.
Recommended actions to close the gap
Improving women’s cardiovascular-health outcomes will require prioritization and a strategic investment of resources, leadership, and dedicated time across all areas of health. Despite rising awareness over the past decades about the importance of recognizing women’s heart health, an economic opportunity amounting to $28 billion still exists to prevent the 1.6 million years of life lost because of poor health or premature deaths in women in the United States.
Stakeholders in the public and private sectors, including employers, not-for-profit organizations, and researchers, have an opportunity to embrace the business of better health. By addressing the existing gap and moving closer to achieving a healthier population, with a specific focus on women’s heart health across all age groups, everyone could benefit.
Advance sex-specific research from basic sciences to clinical trials
Research could be meaningfully improved by shifting from a one-size-fits-all approach to prioritizing sex-specific differences:
- Developing more knowledge around women and heart disease relies on a deeper understanding of biological differences. Future research could provide a crucial recognition of the distinctive vulnerabilities that women face across their lives, including during pregnancy.
- Revamping and expanding clinical research initiatives may include conducting clinical trials specifically focused on women at all stages of life. Validating women-centric diagnostic tools and investigating the impact of CVD on vulnerable and intersectional populations could also improve care delivery.
- Additional transparency and disclosure within research, drugs, and devices could lead to national dashboards on giving evidence on sex-based differences. As the evidence base becomes more robust, it could be built into clinical guidelines.
Improve routine health data collection, diagnostics, and treatment algorithms
Effective guidelines and algorithms rely on a foundation of comprehensive data collection and a balanced representation of women across all age groups and health conditions. Collecting women-specific data in a standardized, easily digestible format should become routine. For example, the NIH has branded menstrual cycle information as the “fifth vital sign.”80
Potential avenues to improve routine health data collection and diagnostics include the following:
- Improved diagnostic criteria for women and separate treatment pathways for men and women. There also may be applicability for other specialties—for example, one study found that breast arterial calcification, picked up on routine mammograms, may be a useful surrogate for atherosclerotic cardiac disease.81
- Interoperable wearables that deliver information to providers. Smartphone apps to track heart health, telemedicine, heart health consultations, and wearable devices all empower individuals to keep track of their health. Future efforts may include that data being shared or flagged to a provider if something appears concerning.
- AI assistance. As use of AI accelerates in healthcare settings, institutions could consider setting up continuous monitoring and evaluation of these novel technologies. Such efforts are essential to ensure their effectiveness in improving women’s cardiovascular-health outcomes, access, and care experience.
In all efforts to improve data collection, patient privacy must be paramount. All US-based companies should follow regulations such as the Health Breach Notification Rule, Health Insurance Portability and Accountability Act of 1996 rules, 21st Century Cures Act, and Code of Federal Regulations on information blocking.
Equip healthcare providers across the care continuum
Healthcare providers across the spectrum, including neurologists, PCPs, and ob-gyns, to name a few, could view women’s cardiovascular health as a shared responsibility to improve outcomes. Imagine, for example, creating a standard postpartum health visit that focused on not just the baby or the mom’s obstetric needs but also a comprehensive cardiovascular “debrief” from any high-risk events occurring during pregnancy.
Other actions may include the following:
- Training on how to identify and mitigate potential biases within the healthcare setting. Hospital systems can further strengthen this approach by creating women’s health programs that bring together specialties such as cardiology, obstetrics–gynecology, oncology, and primary care. These specialists could not only serve patients but act as educational hubs for other providers within the hospital setting.
- Expansion of the role that allied healthcare practitioners play in the management of CVD. Many people, such as doulas, midwives, and community workers, can be involved in cardiovascular care in women. For example, tailored, patient-centric, nurse-led interventions focused on self-management strategies have been shown to encourage a sense of ownership over a patient’s health journey and increase the likelihood of sustained positive behavior.82
Raise public awareness on heart health, and tailor prevention strategies across a lifespan
Public-education campaigns continue to play a valuable role in cardiovascular health. Culturally sensitive, accessible materials that raise awareness about risk factors, prevention strategies, and resources can be tailored to help those at risk of developing CVD. There are several additional ways that outreach could occur:
- Educational institutions. This includes teaching sex-based differences, including challenges and opportunities related to women-specific care delivery, in medical-school curricula and throughout medical residency.
- Direct to consumer. Engaging women through trusted channels in the moments that matter. Outreach can occur during pregnancy using pregnancy-specific apps. Baby boomers are the most likely to be on certain social media sites, so using those sites to provide resources within the fields of heart health and menopause may benefit women of that generation.
- Employers. Workplace wellness programs can equip employees with the knowledge and tools to prioritize their heart health, potentially improving overall quality of life and removing absenteeism. Additionally, employers have opportunities to improve health through six modifiable drivers: economic security, mindsets and beliefs, productive activity, sleep, social interaction, and stress.83 Furthermore, employers can examine their boards and C-suites to assess whether they’re meeting their vision of a diverse and inclusive workplace.
Invest in furthering women’s heart health
Investing in businesses and initiatives that improve women’s cardiovascular health could have benefits for patients, society, and investors. By addressing the unmet needs in women’s heart health, businesses can make a substantial impact on the lives of women and potentially tap into a large, underserved market. Here are some items to consider:
- Life science investors that focus on large, underserved markets (such as both heart health and associated conditions) could benefit from the relative lack of other players in this area. Most investments in women’s health have historically focused on reproductive health.
- Employers that focus on heart health through workplace wellness programs or other initiatives could benefit from reduced absenteeism and potentially lower the healthcare costs associated with chronic conditions.
With 60 million US women living with CVD, the time to act is now. Despite recent advances, a health gap in CVD for women still exists. It’s underpinned by limited understanding of the biological differences of women from men and their impact on CVD; women’s underrepresentation in clinical research; lower effectiveness of CVD prevention, diagnosis in women compared with men; and poorer care delivery for women compared with men. Addressing the gap by 2040 could give an annual 1.6 million years of life lost because of poor health or early death back to women. In parallel, it could boost the US economy by $28 billion and the global economy by at least $80 billion.
Closing the woman’s health gap in CVD can’t be done singlehandedly overnight. It will require a consistent and collective effort from various stakeholders, including community leaders, governments, healthcare institutions, individuals, investors, medical and nursing education boards, and workplaces. As women are often the cornerstones of their families, communities, and workplaces, addressing their health equity could have far-reaching effects on all strata of society. This can begin by reframing women’s heart health as a problem for everyone to tackle, not as a “women’s problem.”
Women’s heart health can be improved at every stage of life, and the wide gap reflects tremendous opportunity to improve the quality of life for every woman in the United States. In a new era, the burden of CVD could be erased, and women could better lend their talents, energy, and leadership to every sector of society. By prioritizing accessible healthcare, education, and research related to women’s heart health, a future is possible where millions of women not only live longer, healthier lives, but also contribute their full potential to a thriving global society.
