Healthcare (Commonwealth Union) – Gender specific treatments have been in focus recent year as the healthcare industry attempts to shift towards a more personalized approach.
Researchers are aiming to develop a treatment approach tailored specifically for women to address a condition that has been neglected for decades.
A research team led by the University of New South Walles (UNSW Sydney) in Australia has received backing through the Wellcome Leap VISIBLE program, a global initiative investing over $75 million (US$55 million) into advancing women’s cardiovascular health.
Associate Professor Erin Howden of UNSW Medicine & Health will head the RESTORE clinical trial, which seeks to establish a female-focused treatment strategy for coronary microvascular dysfunction (CMD), sometimes called “invisible heart disease.”
CMD impacts the heart’s smallest blood vessels, which are too fine to be detected using standard angiograms. The condition is significantly more prevalent in women, especially after menopause, and remains poorly understood and lacking effective targeted treatments.
Associate Professor Howden indicated that up to 70% of women who experience chest pain and undergo angiography are told their arteries are clear, yet many continue to suffer from severe angina, shortness of breath and fatigue that can significantly restrict daily activities.
Tests for diagnosing coronary microvascular dysfunction (CMD) are not widely accessible and often involve invasive procedures.
Associate Professor Howden indicated that the condition can profoundly affect women’s everyday lives. She pointed out that alongside debilitating symptoms, those with CMD face up to a four-times higher risk of major cardiovascular events.
She further indicated that at a day-to-day level, when facing angina or chest pain, it restricts the ability of a women to work, with many stating that they lower hours or retire early and there are more negative impacts on mental health together with social lives.
Despite its significant impact, there are currently no therapies that address the underlying biological causes of CMD.
A new approach to treating CMD could transform in the treatment of the condition with specificity to females. At present, women diagnosed with CMD are typically given medications aimed at easing symptoms—treatments originally developed for men with obstructive coronary artery disease.
The clinical trial led by A/Prof. Howden will examine whether two widely available and well-tolerated interventions—transdermal oestrogen and structured exercise training—can help restore damaged microcirculation and improve quality of life for women.
A/Prof. Howden indicated that their study will explore whether correcting oestrogen deficiency in post-menopausal women, alongside structured exercise, can enhance the function of the heart’s smallest blood vessels.
Over a 16-week period, 132 post-menopausal women in Sydney, Melbourne, and Adelaide will receive one or both interventions. Advanced cardiac MRI imaging will be used to assess changes in the function of the heart’s microvasculature.
“If RESTORE shows that transdermal oestrogen and structured exercise can repair the heart’s smallest blood vessels and improve symptoms, it could lead to the first female-specific treatment for a condition that affects millions of women worldwide.
“It would also change the way CMD is understood and treated from a condition often dismissed as ‘nothing serious’, to one that can be actively managed.”
A/Prof. Howden described the backing from Wellcome Leap’s VISIBLE program as a game-changer.
She pointed out that for many years, coronary microvascular dysfunction has starkly highlighted how women’s heart health has been neglected. A/Prof. Howden indicated that it impacts most women who experience chest pain despite having clear arteries, yet there is not a single approved therapy that addresses the condition’s root biological cause.
The Wellcome Leap VISIBLE programme is dedicated to advancing how coronary microvascular disease in women is diagnosed and treated, with the broader goal of lowering the worldwide impact of cardiovascular disease.
It seeks to significantly improve the rate at which women with stable angina are correctly diagnosed and given effective care for CMD, while still ensuring that obstructive coronary artery disease continues to be accurately identified.
