Addressing equity gaps in women’s heart research

Published: 23 September 2024

Women have been historically under-represented in heart research studies. Two researchers from the University of Auckland have been awarded project grants for research that will advance heart health equity for women in New Zealand.

Historically, heart research studies have included more men than women and have been Euro-centric, meaning that heart disease in women and non-European populations has not been as well studied. 

This is partly due to the misconception that women are at lower risk of heart disease. New research, however, is examining the role that sex-specific differences may play in heart disease.

Landmark study aims for balance

Dr Nikki Earle has been awarded a Project Grant to complete crucial biomarker assays and data analysis for the female and Māori participants recently enrolled in the MENZACS study (Multi-Ethnic New Zealand study of Acute Coronary Syndromes). 

Focusing on females will help researchers understand how heart attacks differ by sex, and to identify risk markers for future heart events that are specific to women, such as menopausal status and pregnancy-related conditions.

“Throughout their lifespan, women can experience female-specific risk factors for heart disease, yet these remain largely unrecognised by established risk screening tools,” shares Nikki.

MENZACS began in 2015 and has enrolled over 2,400 New Zealanders who’ve survived their first heart attack, across 10 hospitals from Auckland to Dunedin. An initial grant from the Heart Foundation in 2015 has been pivotal to the success of this landmark study gathering New Zealand-specific data.

Developing new screening strategies to identify people at the highest risk of death or repeat hospitalisation from heart events is the primary study aim, thus enabling targeted prevention and tailored treatments.

The final phase of the study is addressing existing equity gaps in heart research by prioritising female and Māori participants, and the grant will enable Nikki to perform biomarker measurements and genomic analysis to investigate any differences by sex or ethnic group. 

“Focusing on under-represented populations is a crucial step to enable MENZACS to deliver high-impact, clinically translatable findings,” says Dr Gerry Devlin, Heart Foundation Medical Director.

Do sex differences contribute to heart disease?

Another researcher at the University of Auckland, Dr Carol Bussey, will be investigating sex differences in sympathetic neural regulation of the heart, with a separate Project Grant from the Heart Foundation.

Increasing evidence suggests women’s hearts and autonomic nervous systems function differently to men’s but current data is extremely limited. The autonomic nervous system controls the automatic functions of the body, including heart rate and blood pressure. Part of this is the sympathetic nervous system which is responsible for the ‘fight-or-flight’ response.

A wide range of cardiovascular diseases that are more common in women have been linked to dysregulation of the sympathetic nervous system, as well as many other physical changes including perimenopausal symptoms and depression.

Carol’s research will test the hypothesis that there are fundamental sex differences in the sympathetic regulation of the heart that contribute to heart disease.

She aims to answer key questions, such as, are electrical signals and sympathetic nerve activity in the heart different in females? And do these vary across the female hormonal cycle?

“By understanding these essential processes in both men and women, we aim to ensure that diagnoses and treatments are appropriate, effective and safe for every patient,” Carol says.

As Dr Gerry Devlin, Heart Foundation Medical Director explains, “Studies like this are needed to advance biomedical research more equitably and inform care for women with a wide range of heart disease.”