A groundbreaking study recently presented at the ACC Asia 2026 Together with KSC Spring Conference in Gyeongju, South Korea, has shed new light on the intricate dynamics of cardiovascular risk management between sexes, focusing specifically on Korean adults with heart disease. This extensive research, analyzing data collected over nearly a decade, reveals significant disparities between men and women in the awareness, treatment, and control of major cardiovascular risk factors. The findings underscore the urgent need for sex-specific strategies in combating heart disease, a condition that remains a leading cause of mortality worldwide.
The study delved into data from the Korea National Health and Nutrition Examination Survey, spanning from 2014 to 2023, encompassing adults aged 20 and older. Researchers examined key cardiovascular risk factors including hypertension (high blood pressure), diabetes mellitus, dyslipidemia characterized by elevated cholesterol levels, obesity, and smoking habits. By focusing on these major determinants of cardiovascular health, the team was able to evaluate the distribution and management efficacy among subjects with diagnosed heart disease.
Intriguingly, the data revealed that men with heart disease outnumbered women and typically harbored a higher total burden of cardiovascular risk factors. Despite this, women were found to have a higher prevalence of elevated cholesterol levels, indicative of sex-specific biological and possibly hormonal influences on lipid metabolism. These nuances highlight the complex interplay of gender-related factors contributing to disease progression and management outcomes in cardiovascular pathology.
Perhaps most revealing was the paradoxical finding regarding management efficacy. While women demonstrated higher rates of awareness and were more likely to receive treatment for hypertension, diabetes, and hypercholesterolemia than their male counterparts, their control rates — meaning the successful normalization of these risk factors under treatment — lagged behind men. Specifically, women exhibited notably poorer control over blood pressure and cholesterol levels despite comparable or superior treatment engagement, suggesting underlying disparities in treatment responsiveness, adherence, or healthcare delivery.
This discordance between treatment and control is particularly concerning given its potential to exacerbate cardiovascular risk and adverse outcomes among women. The data suggest that current therapeutic approaches may inadequately address sex-specific physiological or pharmacological differences, necessitating tailored interventions. Moreover, the gap in cholesterol management was markedly pronounced during midlife in women, an observation that aligns with known hormonal transitions such as menopause, which profoundly impact lipid profiles and cardiovascular risk trajectories.
These findings carry substantial implications for clinical practice and public health policy. The recognition that women, despite heightened awareness and proactive treatment, are more likely to experience uncontrolled hypercholesterolemia and hypertension calls for enhanced diagnostic vigilance, patient education, and individualized therapy paradigms. It also raises critical questions about whether standard treatment guidelines effectively capture the nuances of female cardiovascular physiology or whether novel therapeutic modalities are warranted.
The longitudinal scope of the study further revealed that sex differences in risk factor management persisted across the decade, indicating systemic challenges rather than transient discrepancies. Such enduring disparities emphasize the importance of integrating sex as a biological variable in cardiovascular research, clinical trial design, and guideline development—a move toward precision medicine that could substantially improve outcomes.
Dr. Seonji Kim, PhD, from the Department of Biomedical Systems Informatics at Yonsei University College of Medicine in Seoul and lead author of the study, highlighted the urgency of this issue: “While men manifest a greater overall burden of cardiovascular risk factors, women are disproportionately affected by inadequate control, particularly with hypercholesterolemia. The observed disparities, especially in midlife women, underscore the critical need for sex-specific clinical strategies to optimize cardiovascular risk management.”
The research methodology employed robust epidemiological techniques, utilizing population-based survey data to generate representative insights into real-world health patterns. The Korea National Health and Nutrition Examination Survey’s structured interviews, clinical measurements, and biochemical assessments provided a comprehensive dataset enabling precise estimation of awareness (knowledge of diagnosis), treatment (pharmacological or lifestyle interventions), and control (achievement of therapeutic targets) rates among participants. Such rigor lends credence to the findings and enhances their applicability beyond the study population.
Furthermore, the investigation into management indicators highlights the multifactorial challenges of cardiovascular care. Uncontrolled risk factors may stem from biological differences, such as sex hormones influencing lipid metabolism, or from sociocultural determinants including healthcare access, patient-provider communication, and adherence behaviors. This complexity requires multidisciplinary approaches that integrate cardiology, endocrinology, behavioral sciences, and health policy to formulate effective interventions.
In light of these compelling findings, cardiovascular health initiatives must evolve to encompass comprehensive, sex-tailored strategies. These may include targeted screening protocols at critical life stages such as menopause, personalized pharmacotherapy accounting for sex-specific pharmacokinetics and pharmacodynamics, and enhanced education campaigns to improve adherence and lifestyle modifications among women. The ultimate goal is to close the gap in risk factor control and reduce the disproportionate cardiovascular morbidity and mortality burden borne by women.
The study presented at the ACC Asia 2026 conference resonates globally, reflecting broader challenges in cardiovascular health equity. With heart disease remaining the leading cause of death worldwide, elucidating sex-based disparities in risk factor management is pivotal. This research contributes valuable evidence advocating for transformation in clinical cardiology — from a one-size-fits-all model to precision care that adapts to the unique biological and psychosocial contexts of men and women alike.
As the American College of Cardiology continues to champion innovation and excellence in cardiovascular care, studies such as this provide essential guidance for clinicians, researchers, and policymakers. Bridging the gap in cardiovascular risk factor control between sexes not only promises improved individual health outcomes but also propels advancements towards a more equitable healthcare landscape. The integration of such sex-specific insights positions the global cardiovascular community to better meet the challenges of heart disease prevention and management in diverse populations.
For further engagement with this research and to request the full abstract or interview with the lead author, inquiries can be directed to Katie Glenn at the American College of Cardiology Press Office via email at kglenn@acc.org.
Subject of Research: Sex differences in awareness, treatment, and control of cardiovascular risk factors among Korean adults with heart disease.
Article Title: Sex-Specific Disparities in Cardiovascular Risk Factor Management: Insights from a Decade of Korean National Data.
News Publication Date: April 2026.
Web References:
http://www.ACC.org
Keywords: Cardiology, Cardiovascular disease, Risk factors, Hypercholesterolemia, Hypertension, Sex differences, Health disparity, Disease management, Public health policy, Precision medicine, Women’s health, Cardiovascular epidemiology.
