Sex Bias Is Increasingly Prevalent in Preclinical Cardiovascular Research: Implications for Translational Medicine and Health Equity for Women

Ensuring that women are adequately represented in clinical trials is recognized as essential for sex equity in health. However, the use of female animal models and sex-based reporting have not been equally enforced in preclinical stages of research, which often precede and inform clinical trials. In 2014, the National Institutes of Health announced that it would require that sex be considered as a biological variable in applications for preclinical research funding,1 yet a reluctance to include female animal models in preclinical experiments persists. Inappropriately inferring experimental findings to both sexes when a single sex is studied or when sex is not specified has the potential to disadvantage women by skewing our understanding of disease processes toward male-predominant patterns and by reducing the likelihood of female-specific therapeutics advancing to the clinical realm. We therefore systematically examined all preclinical cardiovascular studies published in American Heart Association journals with archives spanning at least 10 years ( Circulation , Circulation Research , Hypertension , Stroke , and Arteriosclerosis, Thrombosis, and Vascular Biology [ ATVB ]) for evidence of sex …