{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:53:23Z","timestamp":1791356003373,"version":"4.3.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The American Heart Association's 2021 Scientific Statement on Psychological Health, Well\u2010Being, and the Mind\u2013Heart\u2013Body Connection affirms the critical role contributed by psychosocial factors in cardiovascular disease outcomes, yet the cited resource continues to lack the sex\u2010specific rigor necessary for equitable clinical guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a review of 206 research articles cited in the statement to assess whether studies reported participant sex, reported the percentage of women enrolled, tested for sex differences, and performed sex\u2010disaggregated analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Although 71% of studies disclosed participant sex, only 29% examined results by sex, drew sex\u2010inclusive conclusions (27%), or performed appropriate subgroup analyses (25%). These practices varied significantly by study design: randomized controlled trials, the gold standard of clinical evidence and most relied upon for clinical practice guidelines, had the lowest rates of female\u2010majority (\u226550%) enrollment, while cohort and cross\u2010sectional designs were more inclusive. In pooled meta\u2010analytic data comprising 899 studies, male\u2010only trials exceeded female\u2010only ones, and 16% failed to report sex. Temporal trends revealed no meaningful improvement in sex reporting from 1987 to 2021, despite decades of policy reforms intended to close these gaps. While slight gains in female enrollment and analytic rigor were observed, they remain insufficient to meet the needs of sex\u2010responsive research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our findings reveal a critical disconnect between the clinical importance of psychosocial factors and the sex representation in the evidence used to guide practice. Deliberate reforms in study design and analytic expectations are needed to ensure that future guidelines rest on an equitable foundation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046951","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:21Z","timestamp":1790310501000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sex\u2010Specific Gaps in Cardiovascular Psychosocial Research: An Analysis of Studies Cited in the American Heart Association's 2021 Statement on Psychological Health and Cardiovascular Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8783-2195","authenticated-orcid":false,"given":"Astha","family":"Burande","sequence":"first","affiliation":[{"name":"University of Alberta","place":["Edmonton, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2981-8164","authenticated-orcid":false,"given":"Aksha","family":"Burande","sequence":"additional","affiliation":[{"name":"University of Alberta","place":["Edmonton, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5387-5383","authenticated-orcid":false,"given":"Nicole L.","family":"Tegg","sequence":"additional","affiliation":[{"name":"University of Alberta","place":["Edmonton, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6793-9333","authenticated-orcid":false,"given":"Colleen M.","family":"Norris","sequence":"additional","affiliation":[{"name":"University of Alberta","place":["Edmonton, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031117"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000947"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001289"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001168"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.2766\/30095"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.17226\/2304"},{"key":"e_1_3_1_8_2","unstructured":"National Institutes of Health . NIH policy and guidelines on the inclusion of women and minorities as subjects in clinical research. NIH Grants & Funding2001. Accessed September 19 2025. https:\/\/grants.nih.gov\/policy\u2010and\u2010compliance\/policy\u2010topics\/inclusion\/women\u2010and\u2010minorities\/guideline#ii.\u2010policy."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.04.077"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-022-01048-0"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1422709"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.05.016"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000381"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.29104"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2018.09.012"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001139"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.33549\/physiolres.934593"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-015-0251-9"},{"key":"e_1_3_1_20_2","unstructured":"National Institutes of Health . Consideration of sex as a biological variable in NIH\u2010funded research. 2015. Accessed September 17 2020. https:\/\/grants.nih.gov\/grants\/guide\/notice\u2010files\/NOT\u2010OD\u201015\u2010102.html."},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8561"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2019.8068"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2023.115737"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000351"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.046951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:25:50Z","timestamp":1791354350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.046951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":23,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2026,10,6]]}},"alternative-id":["10.1161\/JAHA.125.046951"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.046951","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2025-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e046951"}}