Strategies and methods to study female-specific cardiovascular health and disease: a guide for clinical scientists

• Type of Material: Article
• Authors: Pamela Ouyang, Johns Hopkins University; Nanette Wenger, Emory University; Doris Taylor, Texas Heart Institute; Janet W. Rich-Edwards, Brigham and Women’s Hospital; Meir Steiner, McMaster University; Leslee Shaw, Emory University; Sarah L. Berga, Wake Forest University; Virginia M. Miller, Mayo Clinic; Noel Bairey Merz, Cedars-Sinai Heart Institute
• Language: English
• Date: 2016-03-31
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © Ouyang et al. 2016. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13293-016-0073-y
• Title of Journal or Parent Work: Biology of Sex Differences
• ISSN: 2042-6410
• Volume: 7
• Start Page: 19
• End Page: 19
• Grant/Funding Information: This work was supported by the CVD Network Grant from the Society for Women’s Health Research, and partial support from several other funders (listed in full text of the article).
• Keywords: FUNCTIONAL HYPOTHALAMIC AMENORRHEA; POLYCYSTIC-OVARY-SYNDROME; AMERICAN-HEART-ASSOCIATION; GLYCOPROTEIN IIB/IIIA INHIBITORS; Genetics & Heredity; Endocrinology & Metabolism; Cardiovascular disease; Cardiology; ISCHEMIA-SYNDROME-EVALUATION; PRESERVED EJECTION FRACTION; CORONARY-ARTERY-DISEASE; Women; CHILDHOOD TRAUMA QUESTIONNAIRE; Sex-specific; Life Sciences & Biomedicine; SYNDROME EVALUATION WISE; Science & Technology; QUALITY-OF-CARE
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

BACKGROUND: In 2001, the Institute of Medicine's (IOM) report, "Exploring the Biological Contributions to Human Health: Does Sex Matter?" advocated for better understanding of the differences in human diseases between the sexes, with translation of these differences into clinical practice. Sex differences are well documented in the prevalence of cardiovascular (CV) risk factors, the clinical manifestation and incidence of cardiovascular disease (CVD), and the impact of risk factors on outcomes. There are also physiologic and psychosocial factors unique to women that may affect CVD risk, such as issues related to reproduction. METHODS: The Society for Women's Health Research (SWHR) CV Network compiled an inventory of sex-specific strategies and methods for the study of women and CV health and disease across the lifespan. References for methods and strategy details are provided to gather and evaluate this information. Some items comprise robust measures; others are in development. RESULTS: To address female-specific CV health and disease in population, physiology, and clinical trial research, data should be collected on reproductive history, psychosocial variables, and other factors that disproportionately affect CVD in women. Variables related to reproductive health include the following: age of menarche, menstrual cycle regularity, hormone levels, oral contraceptive use, pregnancy history/complications, polycystic ovary syndrome (PCOS) components, menopause age, and use and type of menopausal hormone therapy. Other factors that differentially affect women's CV risk include diabetes mellitus, autoimmune inflammatory disease, and autonomic vasomotor control. Sex differences in aging as well as psychosocial variables such as depression and stress should also be considered. Women are frequently not included/enrolled in mixed-sex CVD studies; when they are included, information on these variables is generally not collected. These omissions limit the ability to determine the role of sex-specific contributors to CV health and disease. Lack of sex-specific knowledge contributes to the CVD health disparities that women face. CONCLUSIONS: The purpose of this review is to encourage investigators to consider ways to increase the usefulness of physiological and psychosocial data obtained from clinical populations, in an effort to improve the understanding of sex differences in clinical CVD research and health-care delivery for women and men.