Women-Focused and Sex/Gender-Related Cardiovascular Research Funding under Canada’s Sex- and Gender-Based Analysis Policy from 2000 to 2024

BACKGROUND: Cardiovascular disease is the leading cause of death among women, yet women have historically been underrepresented in cardiovascular research. Whether Canada's sex- and gender-based analysis (SGBA) policies have shifted funding toward women-focused and sex/gender-related cardiovascular research remains unclear. OBJECTIVE: To examine time trends in Canadian Institutes of Health Research (CIHR) investment in women-focused cardiovascular research and assess changes associated with milestones for CIHR SGBA policy implementation, including mandatory application-level requirements in 2010 and grant criteria assessed by reviewers in 2018. METHODS: We conducted a longitudinal study using CIHR funding data from fiscal years (FYs) 2000 to 2024. Women-focused cardiovascular research projects were identified through terminology searches in titles, keywords, and abstracts. Annual FY funding proportions were analyzed using interrupted time series segmented regression with interruption points in 2010 and 2018. RESULTS: Among 17,168 cardiovascular research grant records, 11.3% were women-focused research. These grants received 11.9% of total funding over the 25-year period. Funding increased before 2010, declined during 2011 and 2017, and accelerated after 2018. Segmented regression showed a small immediate increase in 2010, followed by a negative post-2010 trend and a significant positive quadratic trend after 2018. CONCLUSIONS: Application-level SGBA requirements had limited influence on national health research investment patterns, yet more recently reviewer-level assessment aligned with increased investment in women-focused research. Strengthening SGBA implementation will require consistent monitoring of sex- and gender-disaggregated data to assess patient outcomes and impact.