Bridging the gender gap in ASCVD prevention: insights from UK primary care professionals

Abstract CVD is the leading cause of death among women globally, accounting for over 1 in 3 female deaths compared with 1 in 20 from breast cancer. Women often experience delayed diagnosis, undertreatment, and worse outcomes following acute coronary events. Sex-specific risk factors are often overlooked in CV risk assessments, contributing to suboptimal prevention. Primary care plays a pivotal role in early detection & management of these risks, yet evidence suggests that awareness & implementation of gender-sensitive strategies remain limited. Purpose To explore how primary care HCPs perceive gender differences in the assessment & management of ASCVD and to identify gaps in awareness and opportunities for improving equitable preventive care. Methods A cross-sectional mixed-methods survey was conducted among 107 primary care HCPs across 2 rural UK counties. Quantitative data used Likert-scale items to assess perceptions, confidence, and barriers in gender-sensitive ASCVD management. Qualitative free-text responses were analysed thematically using Braun and Clarke’s (2006) six-step framework to identify key themes improvement strategies. Results Demographics: General Practitioners (47.5%), Nurse Practitioners (10.1%), Practice nurses (10.1%), Other (32.3%). Majority had >6yrs of experience (67%). 40% of respondents do not agree that gender influences CVD presentation 58% do not believe it affects diagnosis 77% do not perceive gender-based differences in management These findings indicate a significant lack of awareness among HCPs regarding gender disparities in ASCVD management. Major barriers to equitable prevention included socioeconomic & cultural influences, limited patient engagement, time constraints, & insufficient training on sex-specific CVD risk. Qualitative themes: diagnostic bias, limited recognition of sex-specific risk factors, and systemic pressures within time-limited consultations. Women’s cardiovascular symptoms were frequently misattributed to non-cardiac causes such as anxiety or menopause, contributing to delayed diagnosis. Strategies to improve care: Nationwide: awareness campaigns on women’s CVD risk; integration of gender-specific guidance into clinical practice; policy-level funding for longer consultations. Practice level: MDT case reviews; pharmacist-led medication optimisation; gender-tailored community outreach; enhanced clinician training in recognising sex-specific CVD presentations. Conclusions Primary care HCPs demonstrate limited awareness of gender differences in ASCVD diagnosis & management, highlighting an urgent need for targeted education, training, & systemic support. Embedding sex-specific risk assessments into routine women’s health menopause reviews, strengthening MDT collaboration, & integrating gender-sensitive recommendations into national guidelines could improve equitable CVD prevention. Without such measures, women remain at risk of delayed diagnosis and suboptimal ASCVD management.