Research Making a Difference
Research Making a Difference
Women represent a substantial portion of patients with heart, lung, blood, and sleep disorders. For example, women represent about half the deaths from cardiovascular disease. Cardiovascular disease includes high blood pressure, heart disease, heart attack, and stroke.
To improve women’s health, research must consider how sex (biological traits encoded in genes) and gender (social and cultural traits linked to human males and females) influence disease risk, disease expression and outcome, and response to interventions. Some of these chronic conditions are more common, cause different symptoms, or are more likely to be fatal in women than in men. For example:
- Heart disease is the leading cause of death in women, and some types of heart disease, such as coronary microvascular disease and heart attack without coronary artery blockage, are more common in women than in men.
- Chronic obstructive pulmonary disease (COPD) is associated with a higher rate of death in women than in men.
- Asthma is more common and more likely to be severe in women than in men.
- Obstructive sleep apnea has been associated with the development of heart failure in women, but not in men.
- Hormone treatments for women, such as postmenopausal hormone therapy and birth control pills, have been shown to increase the risk for blood clots.
These and other differences between women and men make it critical to ensure the full participation of women in research. Since its inception, the NHLBI has been committed to including women in clinical research.
- NHLBI’s Framingham Heart Study, launched in 1948 as one of the first large studies of cardiovascular disease, was designed from the beginning to include women and men.
- The NHLBI also sponsored the Women’s Health Initiative, which was one of the country’s largest clinical trials of women ever undertaken, recruiting more than 161,000 postmenopausal women to study strategies to prevent heart disease, breast and colon cancer, and osteoporosis.
- In recent NHLBI clinical research, about half of participants have been women.
The NHLBI is meeting the call of the National Institutes of Health (NIH) to account for sex as a biological variable in all research—from preclinical studies involving animal or cell models to clinical trials in humans. Considering sex in the design of scientific studies helps to ensure that results can be applied to women and men and allows researchers to examine sex-related factors that affect health and disease. Beginning in fiscal year 2017, all NIH-funded research applications must explain how biological variables such as sex are factored into research design and analyses.
NHLBI’s women’s health research also seeks to understand the factors that lead to health disparities in minority women. For example, cardiovascular disease is more common in black women than in white women. Black women are also more likely to die of heart disease, and at younger ages, than white women. We support diverse population studies that explore the intersection between women’s health and minority health.
- NHLBI’s Framingham Heart Study, launched in 1948, was designed from the beginning to include men and women.
- The Women’s Ischemia Syndrome Evaluation (WISE) study advanced the understanding of heart disease in women, leading to improved diagnosis and treatment.
- The NHLBI-sponsored Women’s Health Initiative found that hormone replacement therapy does not protect older postmenopausal women from cardiovascular disease.
- NHLBI research is studying risk factors for and causes of preeclampsia and examining how preeclampsia affects women’s future cardiovascular disease risk.
- A recent NHLBI-funded study found that obstructive sleep apnea was associated with the development of heart failure in women, but not in men.
- An NHLBI-funded trial showed that sirolimus is an effective treatment for lymphangioleiomyomatosis (LAM), a rare lung disease that affects women.
In 2016, the NHLBI released its Strategic Vision, which will guide the Institute’s research activities for the coming decade. All the objectives, compelling questions, and critical challenges identified in the plan are important for women’s health. For example, NHLBI research will investigate how molecular, cellular, and systems-level differences between men and women affect the risk for heart, lung, blood, and sleep disorders, as well as the progression and treatment of these disorders. Training the next generation of researchers interested in women’s health and recruiting and retaining women scientists are also high priorities for the NHLBI. The NHLBI is bringing further focus to scientific opportunities in women’s health by working to advance the women’s health priorities in the NHLBI Strategic Vision.
Advancing the Research
The NHLBI is advancing women’s health research and clinical care for women with heart, lung, blood, and sleep disorders in many ways. Learn more about some of our efforts related to women’s health.
We Perform Research
NHLBI’s Division of Intramural Research is actively engaged in research that improves women’s health and explores sex-based differences in heart, lung, blood, and sleep disorders. Specific projects are studying the role of sex hormones in blood disorders and heart disease and advancing the treatment of LAM, a rare lung disease that mainly affects women of reproductive age.
We Fund Research
The research we fund today will help improve women’s health in the future. All NHLBI Divisions support research important to women’s health. This includes research on the causes, diagnosis, prevention, and treatment of many heart, lung, blood and sleep disorders that affect women’s health such as heart disease, asthma, COPD, LAM, sickle cell disease, deep vein thrombosis, anemia, and sleep apnea.
The Promise of Precision Medicine
Through NHLBI’s Trans-Omics for Precision Medicine (TOPMed) program, researchers will use data from studies, such as the Women’s Health Initiative, that are focused on heart, lung, blood and sleep disorders. These data will help researchers better predict, prevent, diagnose, and treat these disorders based on a patient’s unique genes, environment, and molecular signatures. Learn more about NHLBI precision medicine activities.
Leading Women’s Health Research
The Women's Health Initiative (WHI) is a long-term study focusing on strategies to prevent the major causes of death and disability among postmenopausal women. Although the original WHI study completed data collection in 2005, the WHI continues to advance women’s health through extension studies and ancillary studies, such as the Women’s Health Initiative Strong and Healthy Study (WHISH) and the Women's Health Initiative Sleep Hypoxia Effects on Resilience (WHISPER).
Partnering on Sleep Apnea and Pregnancy Outcomes Research
The NHLBI partnered with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in the NuMoM2B study, which found that maternal sleep deficiency and mild sleep apnea during pregnancy increases the risk of pregnancy complications, such as preeclampsia and diabetes. The NHLBI and NICHD are now studying whether the treatment of sleep apnea during pregnancy reduces these risks.
Evaluating Treatment for High Blood Pressure during Pregnancy
The NHLBI-funded Chronic Hypertension and Pregnancy (CHAP) compared different treatments for mild chronic high blood pressure in pregnant women. The trial is also studying the best point during a pregnancy to deliver a baby so that complications that affect both mother and child, such as preeclampsia, are minimized.
Collaborating to Improve Women’s Heart Disease Awareness
The Heart Truth® is a national education program for women that raises awareness about heart disease and its risk factors. It also educates and motivates women to take action to prevent the disease. The NHLBI sponsors The Heart Truth® in partnership with many national and community organizations.
Increasing and Sustaining Research to Reduce the Burden of COPD
The NHLBI, with input from federal and nonfederal partners, developed a COPD National Action Plan to guide stakeholders nationwide in their efforts to reduce the burden of COPD. The NHLBI’s COPD Learn More Breathe Better program seeks to increase the awareness and understanding of COPD and encourage people at risk to get tested.