There remains a persistent gap in age and female representation in major cardiology trials compared to real-world populations, despite modest improvements over 20 years.
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May limit generalizability of trial results to older and female patients; leaves open optimal strategies to close demographic gaps.
Although age and female representation increased over time, the modest trends are unlikely to resolve the persistently wide gaps with actual populational prevalence, especially for coronary artery disease and HF. Representation is modulated by the cardiovascular condition studied and some modifiable protocol elements.
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Nguyên et al. (2018) studied this question.
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