Cited by 1,045Sex and Gender in HealthcareCardiovascular Health and Risk FactorsMenopause: Health Impacts and Treatments

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Sex/Gender Differences in Cardiovascular Disease Prevention: What a Difference a Decade Makes

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Mosca, Lori, Barrett-Connor, Elizabeth, Kass Wenger, Nanette·2011·Circulation

DOI 10.1161/circulationaha.110.968792PMC PMC3362050

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Abstract

O ver the past decade, scientists, healthcare providers, the public, and policy makers have made substantial efforts to improve understanding of the sex/gender* differences in cardiovascular disease (CVD) † and to recognize the importance of heart disease in women.Federal and American Heart Association (AHA) initiatives to raise awareness and to reduce gender disparities in research and clinical care are listed in Table 1.There was a near doubling of the rate of awareness of heart disease as the leading cause of death in women between 1997, when the AHA launched its first campaign for women, and 2009; during that same period, the death rate resulting from CVD decreased by nearly half.[2][3][4] The extent to which efforts to close research gaps and to heighten awareness of heart disease in women are causally linked to lower CVD mortality or have resulted in improved clinical outcomes for women is not established.The purposes of this article are to evaluate contemporary sex/gender differences in the burden of CVD, to assess the impact of recent clinical trials on recommendations for the prevention of CVD in women, and to examine factors that may facilitate or impede quality CVD preventive care in women.Recommendations for the design and analyses of future CVD clinical trials in women are also provided.*Gender is referred to throughout this document as a person's self-representation as male or female or how that person is responded to in social situations on the basis of the individual's gender representation.Gender is shaped by environment and experience.Sex is the classification of female or male according to reproductive organs and functions assigned by chromosomal complement. 1 †Throughout this document, CVD is inclusive of coronary heart disease, stroke, and other atherosclerotic conditions except when national statistics are provided in which CVD encompasses International Classification of Diseases, 10th revision, codes 100 to 199.

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Additional file 1 of Sex-biased genetic regulation of inflammatory proteins in the Dutch population
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Additional file 1 of The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies
Angaw, D. A., Ali, R., Tadele, A., & Shumet, S. (2021) · Figshare · doi:10.6084/m9.figshare.13605409
Additional file 5 of The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies
Angaw, D. A., Ali, R., Tadele, A., & Shumet, S. (2021) · Figshare · doi:10.6084/m9.figshare.13605421
Additional file 4 of The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies
Angaw, D. A., Ali, R., Tadele, A., & Shumet, S. (2021) · Figshare · doi:10.6084/m9.figshare.13605418
Additional file 1 of Sagittal abdominal diameter and its socioeconomic correlates: perspective of sex differences
Li, C., Harris, M., Tsilimingras, D., Liu, S. Z., Sheng, Y., & Liu, X. (2021) · Figshare · doi:10.6084/m9.figshare.14205165
Additional file 1 of Sex differences in systemic metabolites at four life stages: cohort study with repeated metabolomics
Bell, J. A., Santos Ferreira, D. L., Fraser, A., Soares, A. L. G., Howe, L. D., Lawlor, D. A., Carslake, D., Smith, G. D., & O’Keeffe, L. M. (2021) · Figshare · doi:10.6084/m9.figshare.14100471
Additional file 2 of Sex-biased genetic regulation of inflammatory proteins in the Dutch population
Boahen, C. K., Abee, H. S., Ponce, I. R., Joosten, L. A. B., Netea, M. G., & Kumar, V. (2024) · Figshare · doi:10.6084/m9.figshare.26678450
Additional file 1 of Activity-to-sedentary ratio provides novel insight into mortality reduction among male survivors of cardiovascular disease in the United States: national health and nutrition examination survey, 2007–2014
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Additional file 3 of The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies
Angaw, D. A., Ali, R., Tadele, A., & Shumet, S. (2021) · Figshare · doi:10.6084/m9.figshare.13605415
Additional file 1 of Demographic changes in COVID-19 mortality during the pandemic: analysis of trends in disparities among workers using California’s mortality surveillance system
Gebreegziabher, E., Bui, D. P., Cummings, K. J., Frederick, M., Nguyen, A. D., Collins, C., Melton, D., Yang, A., Jain, S., & Vergara, X. P. (2024) · Figshare · doi:10.6084/m9.figshare.26746859
Additional file 2 of The prevalence of cardiovascular disease in Ethiopia: a systematic review and meta-analysis of institutional and community-based studies
Angaw, D. A., Ali, R., Tadele, A., & Shumet, S. (2021) · Figshare · doi:10.6084/m9.figshare.13605412
Additional file 1 of Sex-specific differences in the clinical profile among psychiatric patients with pulmonary Embolism: a hospital-based retrospective study
Kong, L., Lu, Y., Han, D., Liu, T., & Bai, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26122638
Additional file 2 of Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study
Cesaroni, G., Mureddu, G. F., Agabiti, N., Mayer, F., Stafoggia, M., Forastiere, F., Latini, R., Masson, S., Davoli, M., & Boccanelli, A. (2021) · Figshare · doi:10.6084/m9.figshare.14131172
Additional file 1 of Sex differences in coronary angiographic findings in patients with stable chest pain: analysis of data from the KoRean wOmen’S chest pain rEgistry (KoROSE)
Kim, H.-L., Kim, H.-J., Kim, M., Park, S. M., Yoon, H. J., Byun, Y. S., Park, S. M., Shin, M. S., 홍경순, & Kim, M.-A. (2022) · Figshare · doi:10.6084/m9.figshare.17798367
Associations of the Triglyceride-Glucose Index with Kidney Function Decline, Cardiovascular Disease Events, and All-Cause Mortality Across Different Glucose Tolerance Statuses
Mao, B.-B., Xiang, Y., Luo, P.-Q., Li, D., Guo, Y., Meng, X., Kan, R., Pan, L.-M., He, Y., Wang, S.-Y., et al. (2025) · Current Medical Science · doi:10.1007/s11596-025-00146-9
Sex-and-Gender Differences in Cardiovascular Risk Factors and Their Correlates Among Adults in Freetown, Sierra Leone: A Population-Based Health-Screening Survey
Russell, J. B. W., Koroma, T. R., Sesay, S., Samura, S. K., Lakoh, S., Bockarie, A. S., Abiri, O. T., Kanu, J. S., Appiah, L. T., Coker, J. M., et al. (2025) · Archives of Internal Medicine Research · doi:10.26502/aimr.0231
Implementation of a cardiovascular toolkit in primary care increased women Veterans’ engagement in behavior change programs: results from a non-randomized stepped wedge trial
Farmer, M. M., Hamilton, A. B., Finley, E. P., Lee, M. L., Chanfreau, C., Than, C. T., Brunner, J., Schweizer, C. A., Huynh, A. K., Moin, T., et al. (2026) · BMC Family Practice · doi:10.1186/s12875-025-03158-5
Sex disparities in deep learning estimation of ejection fraction from cardiac magnetic resonance imaging
Kaur, D., Shad, R., Kumar, A., Mathur, M., Cho, J., Fong, R., Zakka, C., Phillips, C. M., & Hiesinger, W. (2026) · npj Digital Medicine · doi:10.1038/s41746-025-02330-6
Evaluating a Preventive Heart Health Program for Women at Midlife: Protocol for a Mixed Methods Pilot Study
Chiang, G. S. H., Tan, C. E., Tioh, C. M. L., Lee, E. W. X., & Wang, L. Y.-T. (2026) · JMIR Research Protocols · doi:10.2196/83574

Authors: Mosca, L., Barrett-Connor, E., & Kass Wenger, N.
Affiliations: Emory University (US)
From the Columbia University Medical Center, New York, NY (L.M.); University of California San Diego School of Medicine, La Jolla (E.B.-C.); and Emory University School of Medicine, Atlanta, GA (N.K.W.).
ORCID: Barrett-Connor, Elizabeth
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-11-08
Volume: 124
Issue: 19
Pages: 2145-2154
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.110.968792
PMC: PMC3362050
OpenAlex: W2155311570
Cited by: 1,045
References: 91
Citations by year: 2026: 53 · 2025: 97 · 2024: 93 · 2023: 82 · 2022: 106 · 2021: 127 · 2020: 91 · 2019: 79 · 2018: 75 · 2017: 83 · 2016: 40 · 2015: 47 · 2014: 32 · 2013: 27 · 2012: 11
FWCI: 22.30
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (K24HL076346, K24 2HL076346-06)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: sex differences, gender differences, cardiovascular disease prevention, heart disease in women, cardiovascular mortality, gender disparities in research
MeSH terms: Adult, Aged, Cardiology, Coronary Disease, Female, Health Policy, Humans, Male, Middle Aged, Mortality, Risk Factors, Sex Characteristics, Prevalence, Women's Health, Risk Reduction Behavior

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Sex/Gender Differences in Cardiovascular Disease Prevention: What a Difference a Decade Makes

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