Professor Vijay Kunadian
National Specialty Lead for Cardiovascular Disease, National Institute for Health and Care Research (NIHR)
Professor Amitava Banerjee
National Specialty Lead for Cardiovascular Disease, National Institute for Health and Care Research (NIHR)
Cardiovascular disease is a leading cause of death in women. Better treatments are needed, so it’s vital that female patients with the condition participate in research studies.
It’s time to shatter the myth that only men are affected by cardiovascular disease (CVD), such as high blood pressure and stroke. In reality, it’s a leading cause of death in women in the UK and worldwide.
Cardiovascular disease risk in women
Women face additional CVD risk factors, including those related to pregnancy (such as preeclampsia, eclampsia and gestational diabetes) and menopause. Moreover, a high proportion of women with long-term health conditions, such as cancer, develop cardiovascular disease; while research shows that exposure to poor maternal health ‘in utero’ may increase the risk of a woman’s children developing CVD in later life. So, it’s vital that all women — and their clinicians — understand that CVD doesn’t discriminate and are aware of its symptoms.
“Take coronary artery disease, which kills one in 14 women in the UK,” says Professor Vijay Kunadian, National Specialty Lead for Cardiovascular Disease, National Institute for Health and Care Research (NIHR). “Yet, because it’s perceived as ‘a male disease,’ a clinician may not initially think that a woman with symptoms will have a heart issue.”
Consequences of lack of awareness
As an example, Prof Kunadian highlights the case of a 35-year-old female — a heavy smoker — who went to her doctor complaining of chest discomfort. After examination, the patient was prescribed antibiotics and sent home. However, she still felt unwell two days later, so she returned to her doctor and was prescribed indigestion medication.
It was only when she was taken to hospital in an ambulance six days later that the patient had an ECG; the results of which were suggestive of a major heart attack. This lack of awareness could have been fatal. “She is lucky to have survived,” says Prof Kunadian. “This (state of affairs) can’t be ignored anymore because most cardiovascular disease, and particularly coronary artery disease, is highly preventable.”
All the treatment and preventions
that we access or provide come
from clinical research.
Making it easier for women to access trials and research
One reason why women with CVD have been under-diagnosed and under-treated is because they have been under-represented in clinical research. In 2021, the Lancet Women and Cardiovascular Disease Commission published a series of new recommendations to reduce the global burden of CVD in women by 2030. These included appropriate representation of women in clinical trials and prioritising sex-specific research.
There are various factors behind low female research participation, notes Prof Kunadian, who works on the Commission. “For example, women may feel they don’t have time because of their caring responsibilities. It’s also about gaining trust. When I explain a study to a woman, it can take a lot longer because she typically has a lot of questions.”
Why research is vital for patient care and treatment
Professor Amitava Banerjee, National Specialty Lead for Cardiovascular Disease, NIHR, agrees that it must be made easier for male and female patients to seamlessly enter clinical trials and research.
“This can be challenging because they may view research as an extra hurdle to cross when they simply want quick treatment,” he says. “Yet, without that research, quick treatment would not be possible. When we explain this — and that it will potentially give them exposure to better treatment and increase our knowledge to benefit all patients — they tend to say ‘yes’.”
How to take part in clinical research
It’s important to get involved because research saves lives, says Prof Kunadian. “All the treatment and preventions that we access or provide come from clinical research,” agrees Prof Banerjee. “Without it, we can’t advance.”
Anyone interested in taking part in clinical research — including patients with a health condition, such as CVD, or those with no health condition — can find studies and register their interest via NIHR’s Be Part of Research website. The website helps people across the UK make informed decisions about taking part in research; explaining what research is and how you can get involved.
