Advancing women’s heart health and the careers of rising cardiovascular researchers 

In celebration of International Women’s Day on 8 March, the Office for Health and Medical Research spoke to Associate Professor Sarah Zaman about her groundbreaking work, which aims to improve health outcomes for women with heart disease in Australia and all over the world.

Cardiovascular disease is the leading cause of death for women worldwide and second to dementia as the leading cause of death for women in Australia. Passionate about advancing women’s cardiovascular health, Associate Professor Sarah Zaman, an Academic Interventional Cardiologist at Westmead Hospital, is engaged in research to improve patient care, outcomes and policy for women with heart conditions. Zaman is also a Principal Research Fellow at the Westmead Applied Research Centre Faculty of Medicine and Health at the University of Sydney.

In recognition of her pioneering body of work, Zaman recently received the Ministerial award for Rising Star in Cardiovascular Research. During her acceptance speech at the NSW Cardiovascular Research Network Showcase on 27 February this year, she spoke of the many benefits of the Network, which include supporting researchers, mentorship and collaborations. She also highlighted the support she has received from the Office for Health and Medical Research, through a Cardiovascular Elite Postdoctoral Researcher Grant.

Zaman’s nationally and internationally acknowledged work includes 105 publications. One research paper, published in 2023, identified gaps in care for women with a heart attack and that paper resulted in inclusion of new sections on heart attacks in three clinical practice guidelines, including Australia’s Therapeutic Guidelines. Another publication in the journal, Circulation on Women in Cardiology has helped to lead international discussions on greater gender equity for women in relation to heart disease. Zaman was also recently invited to join the Lancet Commission on Ischaemic Heart Disease, working with international leaders to produce a report to impact policy change globally. In addition, she has just finished writing the Heart Foundation’s Acute Coronary Syndrome Guidelines for Australia.

To mark International Women’s Day and recognise female researchers involved in novel discoveries to improve women’s health, we spoke to Zaman about her trailblazing work:

How did it feel to recently receive the Ministerial Award for Rising Star in Cardiovascular Research?
“It felt like a huge privilege as it recognises the important work that my team and I are engaged in, to further health equity for women and improve coronary heart disease health outcomes for patients.”

Why is it so important that we conduct more research into women’s heart health?
“Heart disease in women has been historically under-recognised, under-treated and under-researched. Large-scale studies indicate that for women with myocardial infarction (a heart attack), which is the most common kind of heart disease in females, the time to diagnosis and life-saving treatment is longer than for males and the death rate is higher. Women also have different cardiovascular risk factors to men, such as conditions that occur during pregnancy including pre-eclampsia (which causes high blood pressure), gestational diabetes and gestational hypertension. These confer a 60-70% increased risk of heart disease, on top of traditional factors.

What led to your current research focus?
“As an interventional cardiologist, I could see large knowledge gaps, particularly in relation to younger women with heart attacks caused by spontaneous coronary artery dissection (SCAD), a heart event where 90 percent of those affected are women. This condition is not due to blocked arteries but is caused by a sudden bleed in the heart artery wall and is a common cause of heart attacks in women under 50 years. I am currently part of a world-first international academic group that is pioneering the first global, randomised trial in people with the condition, to help establish best treatment options.”

How has the Office for Health and Medical Research supported your work?
“In 2020, I received a NSW Health Cardiovascular Elite Postdoctoral Researcher Grant from the Office to conduct research into women’s heart disease and female dominant causes of heart attacks. This grant enabled me to start a women’s heart disease research program, set up my research team, recruit PhD students and establish and run largescale cardiovascular clinical trials and cohort studies. The grant also helped to fund the Australia New Zealand SCAD registry for my large cohort study, which involved recruitment of patients with the condition, from 23 hospitals in Australia and NZ.

The resulting research has led to important findings. This includes the discovery that a standard antiplatelet therapy used for heart attacks caused by blocked arteries (atherosclerosis), is harmful for women with sudden coronary artery dissection events. We anticipate that this research may change the standard of care for those patients.”

How do early and mid-career grants support career progression?
“By funding my work, the Office enabled breakthrough research. As a result, I have secured three National Heart Foundation grants (a Future Leader Fellowship, 45 and Up Grant and a Vanguard Grant). I have also been privileged to be awarded a 2026 National Health and Medical Research Council Investigator Grant.”

What is on the horizon in your work?
“I am undertaking a national trial, funded by the Heart Foundation, to determine if a CT calcium scan of the heart arteries can pick up cholesterol plaque many decades before diagnosis of coronary heart disease in women. I have also been invited to co-Chair the international Task Force, writing the 5^th Universal Definition of Myocardial Infarction (a collaboration between the European Society of Cardiology, American College of Cardiology and World Heart Federation). In this role, I hope to better define the diagnosis of heart attacks that occur secondary to spontaneous coronary artery dissection events. I also hope to use this definition document to work with the World Health Organisation to update international classification of diseases codes used globally to define and collect data on heart attacks.”