Underrepresentation of Women in Cardiovascular Clinical Trials Revealed

Despite cardiovascular disease remaining the leading cause of death among women worldwide, research indicates that women are significantly underrepresented in clinical trials for common heart conditions. A recent study conducted by investigators at Cedars-Sinai's Smidt Heart Institute, presented at the ESC Congress 2025 in Madrid, analyzed data from 1,079 cardiovascular trials registered on ClinicalTrials.gov between 2017 and 2023. The findings revealed that women constituted only 41% of the overall trial participants, with even lower participation in studies of coronary heart disease, acute coronary syndrome, and stroke. Researchers employed a participation-to-prevalence ratio (PPR) to assess whether the proportion of women in trials reflected the actual prevalence of these conditions among women, uncovering a notable disparity. Notably, younger women aged 19 to 55 were more likely to participate than older women aged 61 and above. The study suggests that enrollment strategies often halt once a certain number of participants is reached, which may contribute to the imbalance. Experts recommend enhancing outreach efforts targeted at women to improve their representation in cardiovascular research, ensuring findings are applicable to the populations most affected. Dr. Martha Gulati emphasized the importance of balancing participant ratios to better mirror real-world demographics, advocating for continued efforts to make clinical trials more inclusive for women. Overall, increasing female participation in research is essential for advancing understanding and treatment of cardiovascular diseases in women and ensuring equitable healthcare outcomes.