Photo by Marek Studzinski on Unsplash

Women's Health

New Insights into Cardiovascular Disease in Women from the Framingham Heart Study

Findings have important implications for sex-informed risk assessment, prevention, and clinical care.

For most of the 20th century, cardiovascular disease (CVD) was perceived to be a predominantly male condition, leading to systematic under-recognition and under-treatment in women. Since its inception in 1948, the Framingham Heart Study (FHS), one of the longest-running epidemiological studies in the world, has changed this understanding by demonstrating that CVD is not only a major cause of morbidity and mortality in women, but that certain risk factors and subtypes of CVD may affect women more severely than men.

Using published reports with Framingham Heart Study data collected during nearly eight decades of follow-up, researchers concluded that women’s CVD is biologically different than CVD in men, and not just a delayed manifestation. These findings underline the need for risk assessment, prevention, and clinical care of CVD separately for men and women.

Investigators need to place more emphasis on studying women’s cardiovascular health, and the FHS is a unique setting to lend its rich data to translate decades of epidemiologic insight into more precise, equitable, and effective CVD prevention and care for women.

Corresponding author Vanessa Xanthakis, PhD

“Investigators need to place more emphasis on studying women’s cardiovascular health, and the FHS is a unique setting to lend its rich data to translate decades of epidemiologic insight into more precise, equitable, and effective CVD prevention and care for women,” says corresponding author Vanessa Xanthakis, PhD, associate professor of medicine at Boston University Chobanian & Avedisian School of Medicine. 

The researchers synthesized key findings from published FHS investigations across its six cohorts that were relevant to women’s cardiovascular health and risk of CVD. They observed greater implications that exist regarding diabetes, high blood pressure, high cholesterol , and multiple other CVD risk factors for women compared to men. They also highlighted the importance of studying underlying mechanisms of CVD during a woman’s transition to menopause, a concept that is not feasible to study among men.

According to the researchers, far from being protected or spared, women experience a substantial lifetime burden of CVD, often with later onset but greater sensitivity to cumulative risk exposure and more severe downstream consequences. “Substantial knowledge gaps remain for women, underscoring the need for continued and expanded investment in CVD research. The FHS is uniquely positioned to address unanswered questions related to sex-specific disease mechanisms, life-course risk accumulation, hormonal and reproductive influences, novel biomarkers, and emerging phenotypes,” adds Xanthakis, who has been an FHS investigator for the past 15 years

These findings appear online in the Journal of the American College of Cardiology—Advances.