Cardiovascular Health and Disease in Women

Abstract

...In January 1992, the National Heart, Lung, and Blood Institute convened an invitational conference, "Cardiovascular Health and Disease in Women," to highlight new information derived from epidemiologic and clinical research that was appropriate for clinical application and that required wider dissemination and to identify gaps in contemporary knowledge that impeded the delivery of optimal cardiovascular care to women. In addition to addressing general issues of the cardiovascular health of women, this article summarizes the recommendations of the conference....Research should focus on aspects of cardiovascular disease that are unique to women, or areas in which comparisons between women and men are unavailable or inadequate. When elderly people are underrepresented in research studies, women are disproportionately excluded. Women should be encouraged by their physicians to participate in research studies; adequate diversity in terms of age, race, ethnic group, culture, and socioeconomic status should be present in the groups of women studied. Prerandomization stratification according to sex has been recommended for large clinical trials to permit separate evaluation of the sexes. The infrequent inclusion of women in clinical research until very recently warrants scrutiny to clarify whether women have been excluded from participation for medical reasons (such as existing illnesses) and why they have not participated in research studies for which they do qualify. Few registries from large clinical trials are available for evaluation of the outcomes of women who did not participate in the randomized trial; such information would be useful in identifying the reasons for women's nonparticipation and clarifying whether those women fared differently from the participants.