Sex matters? Sex matters!

Improved understanding of the development and prevention of coronary artery diseases has led to a >60% reduction in deaths from heart attack and stroke over the past four decades1; however, alarmingly, the lowest rate of improvement over the past 20 years has been in younger women. Retrospective analyses of previous basic research studies, clinical trials, and care management have taught us that major bias has been introduced by focusing attention on male subjects, particularly in research into cardiovascular disorders. We observed that mortality in women (<50 years old) in the context of myocardial infarction was twice that in men.2 The causes of this discrepancy are multiple and include under-diagnosis of women, as well as less frequent administration of (appropriate) drugs and use of relatively fewer invasive exams or therapies. Delay in care management and shorter stay in intensive care units are also more common for women than men.3 Although this sex gap is increasingly recognized in research, it has yet to be fully addressed, as stratification of data by sex remains uncommon.

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