Nearly 30 years ago, scientists agreed that for clinical trial results to be valid for both sexes, they needed more women.

Yet women seem to be a lot less likely to sign up for clinical trials for cardiovascular disease. The authors of a new paper outline the issue as to why:

Differential Care – Low rates of referral to cardiologists and specialty programs for more aggressive care might lead to fewer women being treated by specialists recruiting for clinical trials.

Ageism – Older patients are disproportionately represented in clinical trials overall, which is further compounded in women as cardiovascular disease is very prevalent in older women.

Lack of Awareness, Trust and Logistical Barriers – Previous surveys and studies have shown that women are more reluctant than men to participate in clinical trials.

Study Retention – Little is known about potential sex differences in study drug discontinuation and patient follow up once patients are successfully enrolled since reasons for study drug discontinuation and withdrawal of consent are not routinely captured in clinical trial case reports.

Has all of this made a huge difference in outcomes? No, there is no giant disparity in heart attacks because studies have more men. We're all still humans so female and male biology can't be considered too distinct in a world where epidemiologists claim rat studies mean trace chemicals might cause cancer in people.