Broadening Access to Cardiovascular Care for Female Patients, With Emily Lau, MD

Virtual shared medical appointments (SMAs) are a feasible solution for closing care gaps for female patients with elevated cardiometabolic risk and/or established cardiovascular disease, based on a recent study.1

Cardiovascular disease is the leading cause of death among women in the US. An increasing amount of evidence regarding sex- and gender-based differences in cardiovascular disease outcomes has indicated the necessity of more efficient approaches to screening.2

These data were presented at the American Heart Association’s Scientific Sessions 2025 in New Orleans, Louisiana, by Emily Lau, MD, cardiologist at Massachusetts General Hospital and Assistant Professor of Medicine at Harvard Medical School, and colleagues. The team collaborated with Systole Health, a group virtual care organization, to design the study.1

The editorial team at HCPLive sat down with Lau to discuss the importance of enhancing access to cardiovascular care for women. Lau discussed the factors she sees as driving these treatment gaps.

“I think it’s largely due to a number of reasons. I think that, as physicians, we often see an implicit bias to be less aggressive with our prevention goals in female patients,” Lau told HCPLive. “There is also an access issue; many of our female patients are caregivers themselves, and what is often least prioritized is their own health. And finally, I think there’s a public health education messaging issue, which is to say that despite decades of research demonstrating the opposite, women still think of heart disease as a man’s disease.”

Systole Health enrolled 13 individual cohorts, each consisting of 3 to 5 women, into a 6-week cardiovascular prevention program across 16 US states. Patients were eligible for inclusion if they had documented or self-reported overweight or obesity, hypertension, dyslipidemia, prediabetes, and/or established cardiovascular disease. Patients were excluded if they had unstable cardiovascular disease or were pregnant.1

The program included weekly physician-led SMAs, lifestyle health coaching, and peer support. A subset of patients was offered medication management, depending on clinical need. Investigators assessed outcomes, which included self-reported body mass index (BMI), blood pressure, and LDL-C, at baseline and at completion of the program.1

Ultimately, 45 women enrolled, collectively contributing 247 patient visits. The mean age across all cohorts was 52 +/- 12 years, and 87% of the population was White. Mean systolic blood pressure at baseline was 124 +/- 15 mmHg, diastolic blood pressure was 78 +/- 11 mmHg, LDL-C was 117 +/- 38 mg/dL, and BMI was 33.4 +/- 7.5 kg/m2. The majority of patients had ≥3 unoptimized cardiovascular risk factors (blood pressure ≥130/80, LDL-C above guideline-recommended thresholds, BMI ≥27, and/or A1c ≥5.7%).1

Patients with complete data contributed to a mean change in LDL-C of -35.4% (P = .001), systolic blood pressure of -7% (P < .001), diastolic blood pressure of -3% (P = .27), and BMI of -4.7% (P <.001). Investigators also noted that, among patients receiving medication management (N = 20), 36 titrations were performed (mean 1.8 +/- 1.5 per patient) with a median intensification time of 8 days.1

This alternative and simplified method of accessing critical features of care for cardiovascular disease may enable clinicians to close care gaps with female patients. Lau also spoke on the value of multiple care models.

“I’ll say this as a cardiologist: we really have an access issue,” Lau said. “There are many more patients who need to see us than we can possibly see. We really need to be thinking about different care models. The traditional care model of people coming in for one-on-one visit into the office or hospital is not meeting their expectations or needs.”

References

1. Parmar S, Lee S, Lau E. Closing Prevention Gaps in Women’s Heart Health: Real-World Impact of a Scalable Group Virtual Care Model. Presented at the American Heart Association’s Scientific Sessions 2025. New Orleans, Louisiana. November 8-10, 2025.

2. Adedinsewo DA, Pollak AW, Phillips SD, et al. Cardiovascular Disease Screening in Women: Leveraging Artificial Intelligence and Digital Tools. Circ Res. 2022;130(4):673-690. doi:10.1161/CIRCRESAHA.121.319876