[Women and cardiovascular disease: Why is a gender-sensitive approach essential?]

Cardiovascular disease remains the leading cause of death in women, yet research, diagnostics, and treatment strategies continue to be shaped predominantly by male-centered evidence. This results in delayed diagnoses, misinterpretation of atypical symptoms, and suboptimal therapeutic decisions. A gender-sensitive approach demonstrates that both biological factors ("sex") and psychosocial or structural determinants ("gender") substantially influence risk profiles, symptom presentation, care pathways, and clinical outcomes in women. They present with cardiovascular disease at an older age, accumulate more comorbidities, experience longer pre-hospital delays, and receive fewer invasive diagnostic and interventional procedures. Epidemiological data from Europe and the United States show that despite declining mortality rates, women continue to experience excess mortality and consistent underdiagnosis, particularly in acute care and rehabilitation. This article summarizes current evidence on epidemiology, risk factors, symptomatology, diagnostics, and treatment, and shows that a gender-sensitive approach must be systematically implemented in research, guidelines, and clinical practice to close existing care gaps and sustainably improve cardiovascular health in women.