Despite recent progress in women’s inclusion among clinical trial participants, women remain vastly underrepresented in heart disease trial oversight committees, according to a new study from physician-scientists at the Baylor College of Medicine, the Houston Methodist DeBakey Heart & Vascular Center, and the Mayo Clinic.
“Disparities in trial leadership have downstream implications for cardiovascular health equity. Clinical trial leadership influences which research questions are prioritized, which patient populations are included, how endpoints are selected, and how results are interpreted and disseminated,” the authors write. “As such, disparities in leadership may contribute to inequities in the evidence base that informs clinical practice.”
The research team analyzed the gender representation of the oversight committees of interventional structural heart disease (SHD) trials published in high-impact journals between 2010 and 2025. Among the 88 trials that met the eligibility criteria, women represented 47 percent of enrolled participants. A trial oversight committee was reported in 67.8 percent of publications and committee member names were listed in 55.8 percent.
Among the trials with committee member information, there were 512 total committee seats, of which just 36 (7 percent) were held by women. Over half (56.2 percent) of the analyzed committees were composed entirely of men. Women were also infrequently represented in formal leadership roles, with only 12 percent of trials overall featuring a woman as committee chair. Among these trials’ authors, women represented 8.1 percent of first authors and 5.8 percent of last authors. Only 14 percent of trials had a woman in either the first- or last-author position.
Notably, this gender gap remained relatively unchanged over the study period. In 2010, women’s representation on committees for interventional SHD trials was around 5.1 percent. By 2025, representation only grew to 6.7 percent. There was a numerical increase in women holding committee chair or leadership roles over the 15-year period, but this did not reach conventional statistical significance.
“In summary, interventional SHD may now be studying women more intentionally than ever before, but trial leadership has not yet evolved at the same pace,” the authors conclude. “Efforts are needed at each stage of the pathway: increasing the number of women who enter interventional cardiology, supporting access to SHD training, and creating transparent pathways into trial leadership.”