Women make up nearly half of participants in major structural heart disease trials, but they remain largely absent from the committees shaping how those studies are run.
Women held just 7% of steering committee seats across high-impact structural heart disease trials published from 2010 to 2025, according to a systematic review and meta-analysis published in JACC: Advances. More than half of the committees studied had no women at all — a gap researchers found has barely changed over 15 years.
The findings point to a divide that extends beyond patient enrollment: Even as cardiovascular research moves closer to gender parity among trial participants, leadership of the trials generating that evidence remains overwhelmingly male.
Here are four findings from the study:
1. Women held just 7% of steering committee seats in high-impact structural heart disease trials published between 2010 and 2025, according to a systematic review and meta-analysis in JACC: Advances. The study, led by Sahar Samimi with senior author Mayra Guerrero, MD, analyzed 88 eligible trials covering aortic, mitral, tricuspid, left atrial appendage occlusion and patent foramen ovale procedures.
2. Researchers found women filled 36 of 512 total committee seats identified across the trials. More than half of committees, 56.2%, were composed entirely of men. Women served as committee chair or leader in 12% of trials and held the first- or last-author position in 14% of publications, despite making up 48.8% of trial participants.
4. Representation showed no significant improvement over time. The pooled proportion of women on committees rose only from a model-implied 5.1% in 2010 to 6.7% in 2025 (OR per year: 1.02; 95% CI: 0.93-1.12; P = 0.70). Women’s presence as committee chair increased numerically but did not reach statistical significance (OR per year: 1.41; 95% CI: 1.05-2.34; P = 0.075). Representation was lowest in aortic trials, at 1.6%, and highest in left atrial appendage occlusion trials, at 11.9%.
4. The authors point to structural barriers beyond the workforce pipeline, including sponsorship networks and legacy visibility, and call for transparent, predefined committee selection criteria and mandatory disclosure of trial governance. Dr. Guerrero disclosed institutional research support from Edwards Lifesciences.
5. The findings add to a growing body of research linking diverse trial leadership to more representative patient enrollment and more equitable cardiovascular evidence, as the field works to close gaps that persist despite near-parity in trial participation.
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