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Increasing representation and diversity in cardiovascular clinical trial populations

Nature Reviews Cardiology volume 18, pages 537–538 (2021)Cite this article

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The homogeneity of cardiovascular clinical trial populations limits the generalizability of results and compounds health inequities faced by women, older adults and people of colour. This Comment highlights the importance of diversity in clinical trial populations and describes multifaceted interventions that might help to close the diversity gap in trial enrolment.

Well-designed, randomized clinical trials (RCTs) provide the highest-quality evidence to inform clinical practice. Worldwide, cardiovascular disease remains the leading cause of death for both women and men. Diverse representation of participants in cardiovascular clinical trials is essential in determining the efficacy and safety of interventions across demographic groups defined by age, sex, race, ethnicity and comorbidities. However, women, older adults, Black, Indigenous and other People of Colour (BIPOC), and those with common comorbidities remain under-represented in cardiovascular RCTs relative to the disease distribution in these groups1,2,3,4,5,6. Regulatory agencies and public funding agencies have put forth recommendations to improve inclusivity and diversity in clinical trials; nevertheless, only limited progress has been made1,2,3,4,5,6.

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Fig. 1: Increasing the diversity of participants in cardiovascular clinical trials.

References

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Acknowledgements

E.D.M. is supported by the Amato Fund in Women’s Cardiovascular Health at Johns Hopkins University School of Medicine. H.G.C.V. is supported by funding from the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada.

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Authors and Affiliations

  1. Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Erin D. Michos

  2. Department of Medicine (Cardiology) and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

    Harriette G. C. Van Spall

  3. Population Health Research Institute, Hamilton, Ontario, Canada

    Harriette G. C. Van Spall

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  1. Erin D. Michos
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  2. Harriette G. C. Van Spall
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Correspondence to Erin D. Michos.

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Michos, E.D., Van Spall, H.G.C. Increasing representation and diversity in cardiovascular clinical trial populations. Nat Rev Cardiol 18, 537–538 (2021). https://doi.org/10.1038/s41569-021-00583-8

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