Closing the sex gap in cardiovascular mortality by achieving both horizontal and vertical equity.

Addressing sex differences and disparities in coronary heart disease (CHD) involves achieving both horizontal and vertical equity in healthcare. Horizontal equity in the context of CHD means that both men and women with comparable health statuses should have equal access to diagnosis, treatment, and management of CHD. To achieve this, it is crucial to promote awareness among the general public about the signs and symptoms of CHD in both sexes, so that both women and men may seek timely medical attention. Women often face inequity in the treatment of cardiovascular disease. Current guidelines do not differ based on sex, but their applications based on gender do differ. Vertical equity means tailoring healthcare to allow equitable care for all. Steps towards achieving this include developing treatment protocols and guidelines that consider the unique aspects of CHD in women. It also requires implementing guidelines equally, when there is not sex difference rather than inequities in application of guideline directed care.
Competing Interests: Declaration of competing interest Raffaele Bugiardini has no conflict of interest to declare. Martha Gulati declares: Consultant Fees/Honoraria: Esperion, Novartis, and Boehringer Ingelheim Research/Research Grants: Congressionally Directed Medical Research Program-Department of Defense (WARRIOR study).
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