Cardiology training must urgently integrate sex as a biological variable to address long-standing gaps in women’s cardiovascular care, according to an article published in the Journal of American College Cardiology (JACC). The Viewpoint piece warned that current education models continue to disadvantage female patients across diagnosis, treatment and outcomes. Led by Celina M. Yong, MD, from Stanford University School of Medicine in California, the article’s authors declared that despite decades of evidence, women’s heart health remained siloed rather than embedded into routine cardiology practice. “Few cardiologists receive formal training in women’s cardiovascular health,” they wrote. “Expertise has historically been concentrated in a small number of specialized centers—reinforcing the notion of women as a ‘special population’ rather than integral to general cardiology education and training.” Practical consequences The authors highlighted the practical consequences of inadequate training, emphasizing that shortfalls in sex-specific cardiovascular education still impacted everyday clinical workflows. These gaps, they argue, contribute to early diagnostic closure, inconsistent use of coronary function testing, and ongoing challenges in interpreting stress testing results in women. “Beyond under-representation in research, there has been limited scientific inquiry and training dedicated to conditions that uniquely or predominantly affect women,” the authors noted. The article, which appears in the February 17 edition of JACC, also features emerging trial evidence suggesting that sex-specific differences can significantly influence treatment response. In recent analyses of revascularization strategies, outcomes varied by sex. The authors suggested that these findings would have remained obscured without deliberate sex-stratified evaluation. They concluded that meaningful progress would require women’s cardiovascular health to be taught consistently across cardiology training, including diagnostic imaging, interventional practice, electrophysiology, heart failure and prevention, instead of being siloed within specialist fellowships. Cardiovascular knowledge The authors added that embedding sex-specific cardiovascular knowledge into routine education and clinical practice is essential to improving diagnostic accuracy, therapeutic decision-making and outcomes for both women and men. “Program directors and faculty must teach what is known, acknowledge gaps in evidence, and routinely disaggregate data during grand rounds, morbidity and mortality conferences, and journal clubs,” they concluded. “By standardizing these questions into routine practice, we can encourage the next generation of cardiologists to question, debate, and ultimately develop new conceptual models that drive rigorous clinical trials.” Source: Yong CM, Spatz ES, Hayes SN. Sex Matters: Optimizing Cardiovascular Education and Training to Improve Women’s (and Men’s) Heart Health. J Am Coll Cardiol. 2026;87:742–745. Image Credit: Syda Productions – stock.adobe.com