The Global Burden of Cardiovascular Disease in Women

Introduction

Cardiovascular disease (CVD) remains the leading cause of death among women worldwide, accounting for 1/3 of global deaths in women.¹ Surprisingly, more than 50% of women are unaware of its impact.¹ In the recent ADLM webinar, Women’s Hearts: Biomarkers for Precision-Based Care, Dr. Emily Lau shed light on how emerging biomarkers are bringing precision medicine to the forefront of women’s cardiovascular care.

Sex-based differences in cardiac health

Historically, cardiovascular research and clinical guidelines have been male-centric and diagnosis and management of CVD in women often lag behind those for men.² Symptoms like chest pain dominate diagnostic criteria, but women present with “atypical” signs—simply different from men—such as fatigue, shortness of breath, or nausea,¹ leaving many women at risk of delayed or inaccurate treatment and emphasizing the need for sex-specific criteria and strategies.

More recent studies have shown that there are many sex-associated differences in CVD and CVD risk factors beyond those of the myocardial infarction. For example, women are more likely to be diagnosed with aortic valve stenosis at later stage of disease³ and have differing responses to certain medications.⁴

Females have been underrepresented in biological and clinical studies, and molecular profiling—looking at the genetics and gene expression—may help to identify the pathways leading to sex differences in CVD phenotypes and ultimately treatment for both men and women.⁵

Implementing biomarkers for precision-based care and biological discovery for women with CVD

Biomarkers—measurable indicators of biological processes⁶—are revolutionizing how clinicians assess CVD risk and disease progression. Certain biomarkers provide critical insights into cardiac health, but sex is known to influence the circulating levels of some important biomarkers and may modify the effect of a biomarker on disease outcomes.

• Human Cardiac Troponin (hcTn): Specific cardiac regulatory proteins of the thin filament. Detects subtle myocardial injury and other acute coronary syndromes, enabling earlier intervention.
  • Circulating troponin levels are ~1.5x higher in men than in women, leading to sex-specific cutoffs to improve cardiac diagnosis in women⁷
  • Cardiac troponin levels are more strongly associated with cardiovascular events in women than in men⁷
• BNP and NT-proBNP: Hormones that help maintain cardiovascular homeostasis and can be used as indicators of heart failure
  • Circulating levels are ~2x higher in women than in men, but interestingly, no current guidelines for sex-specific cutoffs⁸
  • More strongly associated with mortality in men than in women⁸
• Inflammatory Markers: Highlight systemic inflammation
  • Tend to be higher in men

Other factors may also differ between men and women and influence the risk of CVD.

The Future of Precision-Based Care in Action

Integrating biomarker data with clinical history and imaging creates a holistic picture of heart health. For women, this may facilitate:

• Earlier Detection: Identifying silent or atypical presentations before they escalate
• Personalized Therapy: Adjusting medication and lifestyle interventions based on biomarker trends
• Better Outcomes: Reducing hospitalizations and improving quality of life through proactive care

The future of cardiovascular care lies in precision medicine—where biomarkers guide decisions, and sex-specific differences are no longer an afterthought. As research expands, clinicians and laboratorians must collaborate to ensure these innovations reach every patient who needs them.

To learn more about the role of biomarkers in women’s heart health and differences between CVD in men and women, explore the full ADLM webinar on-demand: Women’s Hearts: Biomarkers for Precision-Based Care

Learn more about the use of Access hsTnI (High Sensitivity Troponin I Assay) in the emergency department here