Public awareness of sex difference in cardiovascular disease: a nationwide population study
H J Kim, H L Kim, S M Park, H J Yoon, S R Kim, S M ParkAbstract
Background
Sex differences in the pathophysiology, symptoms, and outcomes of cardiovascular disease (CVD) are increasingly recognized. However, public awareness regarding these sex-specific differences remains underexplored.
Purpose
This study aimed to evaluate public perception of sex differences in CVD management and identify sociodemographic factors associated with awareness in the Korean population.
Methods
We conducted a nationwide, stratified, cross-sectional survey of 2,003 adults (aged 20–80 years) in July 2025. Participants were recruited via a proportional allocation method based on age, sex, and region. Awareness of sex differences in CVD symptoms, risk factors, and treatment outcomes was assessed. To analyze factors associated with perception, participants were classified into two groups based on their response to the question, "Do you think sex differences may affect the management of cardiovascular disease?" Those who answered "Strongly agree" or "Somewhat agree" were defined as the high perception group, while those who answered "Somewhat disagree," "Strongly disagree," or "Not sure" were classified as the low perception group.
Results
Among 2,003 participants (mean age 49.5 years; 50.0% women), only 39.7% demonstrated a high perception of sex differences in CVD. While general awareness of CVD was comparable between sexes, specific knowledge regarding female-specific risk factors, sex differences in symptoms, cause, treatment response, and drug efficacy were significantly lower in the low-perception group (p < 0.001). Multivariable analysis revealed that high household income (>5 million KRW) (odds ratio [OR]: 1.45; 95% CI: 1.00–2.12) and a family history of CVD (OR: 1.84; 95% CI: 1.50–2.26) were associated with better awareness. Conversely, unemployment was identified as an independent risk factor for low perception. Notably, female sex was not associated with higher awareness.
Conclusions
Public awareness of sex-specific characteristics in CVD remains low in Korea, with socioeconomic factors playing a significant role. Women are not more aware of sex-specific cardiovascular risks than men, revealing a key gap in public health messaging. Targeted, sex-sensitive education for vulnerable socioeconomic groups is urgently needed to reduce disparities and improve cardiovascular outcomes.Table