Abstract
Despite a global understanding that indicators and outcomes of cardiovascular disease (CVD) are known to differ between men and women, uptake of the recognition of sex and gender influences on the clinical care of women has been slow or absent. The Canadian Women's Heart Health Alliance (CWHHA) was established as a network of experts and advocates to develop and disseminate evidence-informed strategies to transform clinical practice and augment collaborative action on women's cardiovascular health in Canada. As an initial project, the CWHHA membership undertook an environmental scan of CVD in women in Canada from which a scientific statement could be developed to summarize critical sex- and gender-specific issues in CVD. This comprehensive review of the evidence focused on the sex- and gender-specific differences in comorbidity, risk factors, disease awareness, presentation, diagnosis, and treatment across the entire spectrum of CVD. In the process of creating the review, it was recognized that the team of CWHHA experts had also assembled an expansive collection of original research articles that were synthesized into detailed chapters reporting on the present state of the evidence unique to each cardiovascular condition in women. This work comprises an “ATLAS” on the epidemiology, diagnosis, and management of CVD in women. The overall goal of the ATLAS is to create a living document that will help clinicians and the public recognize the unique aspects of women's heart health care and provide policy makers with information they need to ensure equitable care for women with CVD.
| Original language | English |
|---|---|
| Pages (from-to) | 145-150 |
| Number of pages | 6 |
| Journal | CJC Open |
| Volume | 2 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 2020 |
Bibliographical note
Funding Information:Cardiovascular disease (CVD) is the leading cause of premature death for women in Canada. 1 Despite a global understanding that manifestations and outcomes of CVD are known to differ between men and women, uptake of the recognition of sex and gender influences on the clinical care of women has been slow or absent. 2 The Canadian Women’s Heart Health Alliance (CWHHA) was established as a network of experts and advocates to develop and disseminate evidence-informed strategies to transform clinical practice and augment collaborative action on women’s cardiovascular (CV) health in Canada. The CWHHA membership identified as a high priority the need for an environmental scan of CVD in women in Canada from which a scientific statement could be developed to summarize critical sex- and gender-specific issues in CVD diagnosis, treatment and outcomes. Supported by the University of Ottawa Heart Institute (UOHI), the coordinating body of the CWHHA, the CWHHA along with the Heart and Stroke Foundation of Canada (HSFC) undertook a comprehensive review of the evidence regarding sex- and gender-specific differences in comorbidity, risk factors, disease awareness, presentation, diagnosis, and treatment across the entire spectrum of CVD. 3
Funding Information:
Dr Norris has received grants from The Canadian Institute of Health of Health Research. Dr Nerenberg has received grants from Heart and Stroke Canada, Heart and Stroke Foundation of Alberta, and The Canadian Institutes of Health Research. Dr Levinsson has received grants from AstraZeneca, Canada. Dr Mulvagh has received research grants from GE Healthcare, is a member of the Novo Nordisk steering committee, and is a consultant for Lantheus Medical Imaging.
Funding Information:
Supported by the University of Ottawa Heart Institute Foundation.
Funding Information:
However, an initiative led by the CCS in 2018 was undertaken to determine the feasibility and outcomes of a structured process for considering sex and gender in CPGs, specifically for managing ST-segment elevation myocardial infarction. A sex and gender champion was appointed to the guideline development committee. The feasibility of tailoring the CPG to sex was ascertained by recording (1) the male–female distribution of the study population; (2) the adequacy of sex-specific representation in each study using the participation/prevalence ratio; and (3) whether data were disaggregated by sex. The outcome was to determine whether CPG recommendations based on an assessment of the evidence should differ by sex. It was concluded that implementation of a systematic process for critically appraising sex-specific evidence for CPGs was straightforward and feasible; however, inadequate enrollment and reporting by sex hindered comprehensive sex-specific assessment of the quality of evidence and strength of CPG recommendations on the management of ST-segment elevation myocardial infarction. 2 Although gender-specific analyses were deemed not feasible at this time, it was emphasized that going forward it is imperative that results be stratified by sex for clinicians to have the ability to provide sex-specific care. A recognition of the importance of ensuring female participation in CV trials is supported by recently mandated policies of the Canadian Institutes of Health Research 13 and the HSFC requiring sex- and gender-based analysis in funded research. 1 Moreover, equitable representation in research of high CVD risk groups, such as indigenous and ethnic women, is additionally required.
Publisher Copyright:
© 2020
ASJC Scopus Subject Areas
- Cardiology and Cardiovascular Medicine
PubMed: MeSH publication types
- Journal Article
- Review
