Clavel Marie-Annick, Van Spall Harriette G C, Mantella Laura E, Foulds Heather, Randhawa Varinder, Parry Monica, Liblik Kiera, Kirkham Amy A, Cotie Lisa, Jaffer Shahin, Bruneau Jill, Colella Tracey J F, Ahmed Sofia, Dhukai Abida, Gomes Zoya, Adreak Najah, Keeping-Burke Lisa, Limbachia Jayneel, Liu Shuangbo, Jacques Karen E, Mullen Kerri A, Mulvagh Sharon L, Norris Colleen M
Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada.
Department of Medicine, Department of Health Research Methods, Evidence, and Impact, McMaster University, Toronto, Ontario, Canada.
CJC Open. 2023 Nov 17;6(2Part B):220-257. doi: 10.1016/j.cjco.2023.11.013. eCollection 2024 Feb.
Despite significant progress in medical research and public health efforts, gaps in knowledge of women's heart health remain across epidemiology, presentation, management, outcomes, education, research, and publications. Historically, heart disease was viewed primarily as a condition in men and male individuals, leading to limited understanding of the unique risks and symptoms that women experience. These knowledge gaps are particularly problematic because globally heart disease is the leading cause of death for women. Until recently, sex and gender have not been addressed in cardiovascular research, including in preclinical and clinical research. Recruitment was often limited to male participants and individuals identifying as men, and data analysis according to sex or gender was not conducted, leading to a lack of data on how treatments and interventions might affect female patients and individuals who identify as women differently. This lack of data has led to suboptimal treatment and limitations in our understanding of the underlying mechanisms of heart disease in women, and is directly related to limited awareness and knowledge gaps in professional training and public education. Women are often unaware of their risk factors for heart disease or symptoms they might experience, leading to delays in diagnosis and treatments. Additionally, health care providers might not receive adequate training to diagnose and treat heart disease in women, leading to misdiagnosis or undertreatment. Addressing these knowledge gaps requires a multipronged approach, including education and policy change, built on evidence-based research. In this chapter we review the current state of existing cardiovascular research in Canada with a specific focus on women.
尽管医学研究和公共卫生工作取得了重大进展,但在女性心脏健康的流行病学、症状表现、管理、治疗结果、教育、研究及出版物等方面,仍存在知识空白。从历史上看,心脏病主要被视为男性疾病,这导致对女性所面临的独特风险和症状的了解有限。这些知识空白尤其成问题,因为在全球范围内,心脏病是女性的主要死因。直到最近,心血管研究,包括临床前和临床研究,都未涉及性别因素。研究招募对象往往局限于男性参与者,且未按性别进行数据分析,这导致缺乏关于治疗和干预措施对女性患者影响的数据。这种数据缺失导致治疗效果欠佳,也限制了我们对女性心脏病潜在机制的理解,并且与专业培训和公众教育方面的意识有限及知识空白直接相关。女性往往不了解自己患心脏病的风险因素或可能出现的症状,从而导致诊断和治疗延误。此外,医疗保健提供者可能未接受足够的培训来诊断和治疗女性心脏病,进而导致误诊或治疗不足。解决这些知识空白需要采取多管齐下的方法,包括基于循证研究的教育和政策变革。在本章中,我们将回顾加拿大现有心血管研究的现状,特别关注女性群体。