Underrepresentation of Women, Elderly in Cardiology Trials Persists

Despite some improved trends, women and the elderly continue to be underrepresented in cardiology clinical trials, according to a new analysis published in Circulation: Cardiovascular Quality and Outcomes. The researchers looked at the 25 most cited cardiology articles each year between 1996 and 2015, looking at age, percentage of women, funding, sample size, disease condition, intervention type and exclusion criteria. Outcomes of interest included mean age and the percentage of women over time. The analysis included data from over 500 studies. 

Underrepresentation of women and older adults in highly cited cardiology RCTs: Will the gap close soon? @quocdngu @chumontreal https://t.co/5iTfsFrBBx pic.twitter.com/8cXc693CaH

— Circ: CQO (@CircOutcomes) May 31, 2018

According to the results, gaps in representation were pronounced for coronary artery disease (-5.0 years; -27.2% women) and heart failure (-6.0 years; -25.4% women) when compared to population prevalence derived from the National Health and Nutrition Examination Survey. The researchers also reported that mean age and percentage of women over time did increase “slightly but significantly” over time. 

“The current lack of representation means that physicians have to apply findings based on a male-dominant and younger population without being sure that these results should be extrapolated to women or older people in general,” lead author Quoc Dinh Nguyen, professor on the Université de Montreal Faculty of Medicine, said in a news release. 

http://twitter.com/MaasAngela/statuses/1009144855635877888

When will the gap close? When we insist the enrolled represent the prevalence of disease. We need more #women & elderly in trials. Let’s insist studies represent our population. @CircAHA @JAMA_current @NEJM @bmj_latest @TheLancet @mmamas1973 @MinnowWalsh @HeartBobH @JACCJournals https://t.co/rMfMZfRpEp

— Dr. Martha Gulati ♥️🫀❤️‍🩹🇨🇦 (@DrMarthaGulati) June 1, 2018

Very proud to see our analysis of cardiology RCTs published! Unfortunately, based on current trends, it will take many decades before women and older adults are truly represented in studies. @quocdngu @delphineremlab @3rdheartsound https://t.co/wPmRNT3MrM

— Eric Peters (@epetersmtl) June 1, 2018

Do ❤️ RCTs reflect actual population demographics? In our analysis, based on current trends, age and gender-representative enrollment for #HF would require decades! #aging #womenshearthealth @ICMtl @chumontreal @quocdngu https://t.co/FF0fAVUjXo

— Maxime Tremblay-Gravel (@3rdheartsound) June 1, 2018

This ⬇️⬇️is timely following @escardio #HeartFailure Meeting & confirms what I have been saying – we have gap in knowledge in #cardiovascular RCTs for or SuperAgers since mean age is 62.6 ±7 yrs (500 studies) in addiiton to gender gap where only 29% are💃😞 https://t.co/beUJO2BZnn

— Dr Anastasia Mihailidou FAHA FCSANZ FESC (@AnastasiaSMihai) June 1, 2018

Source: Circulation: Cardiovascular Quality and Outcomes