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American College of Cardiology: Health care system changes are needed to improve heart health among women

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Committee’s recommended health care changes should include gender-specific strategies that consider the unique needs of women and minorities

In a review paper published this week in the Journal of the American College of Cardiology (JACC), a special committee convened by the American College of Cardiology (ACC) is calling for health care system improvements to ensure women are receiving the same quality cardiovascular (CV) care that men receive.

The paper aims to promote enhanced awareness, develop critical thinking in sex and gender science and identify strategic pathways to improve the cardiovascular health of women. Changes called for include a women-specific research agenda and clinical trial funding to address the healthcare inequalities faced by women.

"It is precisely when our health care system is in a state of restructuring and championing personalized and precision medicine that opportunities exist for a call to action toward patient-centered, effective care of women at risk for or living with cardiovascular disease," says lead author Leslee Shaw, PhD, professor of cardiology at Emory School of Medicine and member of the ACC Cardiovascular Disease in Women Committee who issued the paper.

According to the Committee, comprised of leading CV physicians and researchers, struggles to achieve high-quality and equitable heart health care today persist for many women and evidence shows that the quality of care women of diverse race and ethnicity receive is suboptimal. As many as 60 million adult women in the U.S. are affected.  

The authors looked at the socioeconomic disadvantages influencing the care of women, including social and cultural determinants of health and disease, how financial disparities influence health-seeking behaviors, the influence of race and ethnicity in equity of care, and the ethical accountability of health care providers and the health care system.

Researchers also sought to define equitable care for women, stating that equity is not always characterized as women and men receiving the same care but that "any adequate concept of equity must incorporate biological differences."

The review paper offers suggestions for creating an equitable health care system that would include prioritizing and funding sex and gender science, personalizing care to meet the needs of specific localities, and requiring public reporting of data to include information on age, sex, race and ethnicity.

"So much of the research on sex-related differences is not funded research," says Shaw, who also serves as the research director for the Emory Women's Heart Center.

Additionally, according to Shaw, there is virtually no enforcement of mandated female enrollment in US trials and little standardization of how sex differences are defined and categorized in clinical research.

"There is no focus on sex-related hypotheses, in prioritization or funding to examine sex-related differences or racial and ethnic differences among women," she adds. "We have to create a culture in cardiovascular medicine that values that reporting."

The full JACC review paper can be accessed here.

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