Finding the answers: Researchers studying sex differences in cardiovascular disease

February 24, 2020  //  FOUND IN: Our Employees,
L-R: Lori Isom, Ph.D., Johann Gudjonsson, M.D., Ph.D., Santhi Ganesh, M.D., Kanakadurga Singer, M.A., M.D.

Did you know that 90 percent of spontaneous coronary artery dissections — which involve a tear in an artery in the heart — occur in women? Or that the standard therapy for heart failure is less effective in women than in men? 

These cardiovascular differences among the sexes are fairly well known in the clinical and research communities. Why they exist, however, is not. And that’s what a group of experts at the Frankel Cardiovascular Center at Michigan Medicine is trying to find out.

In honor of Heart Month, here’s a closer look at M-BRISC, the Michigan Biological Research Initiative on Sex Differences in Cardiovascular Disease.

A unique approach

M-BRISC was created thanks to a generous, anonymous gift to the Frankel Cardiovascular Center. The initiative brings together collaborators from across the university to increase investigation designed to understand the mechanisms of cardiovascular disease that differentially affect women and factors underlying the health of women.

“What sets us apart is that our group includes not only cardiovascular experts,” said Santhi Ganesh, M.D., M-BRISC director and associate professor of cardiovascular medicine and human genetics, “but also other medical disciplines, ranging from pediatrics to dermatology. We also have diverse basic and translational scientific expertise, including cellular molecular biology, genetics and pharmacology.”

Why has M-BRISC opted for this approach?

First, the team members bring a variety of backgrounds and diversity of thought to the table.

“There may be a study or program going on within their area of expertise that can shine a light on how to better approach sex differences in cardiovascular disease,” said Johann Gudjonsson, M.D., Ph.D., M-BRISC co-director.

Secondly, every aspect of human biology is interconnected. Therefore, answers found in skin disease may, in fact, lead to answers in cardiology.

“Psoriasis, for example, is an inflammatory skin condition that is strongly associated with the development of heart disease,” Gudjonsson said. “So bringing in a dermatologist like myself, who has done research on psoriasis, may give insight into cardiovascular disease and how it develops and manifests.”

Breaking down a barrier 

In 2020, there is still a great deal that is unknown about cardiovascular disease in women. That may be surprising, with it being the leading cause of death among women (approximately one in every three women die from cardiovascular disease).

But, as Kanakadurga Singer, M.D. — M-BRISC co-director and assistant professor of pediatrics and molecular and integrative physiology — noted, it’s difficult and oftentimes costly to research the topic.

“Women’s heart disease is historically under-recognized, under-investigated, and under-funded,” said Singer. “On top of that, the majority of clinical trial participants to date have involved male volunteers. To really understand how to best treat women with cardiovascular disease, we need more women to be studied in clinical trials.”

M-BRISC’s plan is to transform the understanding of why women’s hearts differ so greatly from men’s, and to discover treatment and cures ideally suited to women’s distinct needs — with the hopes of increasing participation of women in cardiovascular research, as well.

Coming together

To carry out its work, the M-BRISC team meets routinely to discuss ongoing research projects and solicit feedback from one another.

Rosanne Rouf, M.D.

For instance, Rosanne Rouf, M.D., assistant professor of cardiovascular medicine and M-BRISCs newest co-director, is looking at mitral valve disease and ways it can be treated in women. Her research methods and findings are shared regularly with the M-BRISC community.

The team has also launched a grant program to help fund future research into sex differences in cardiovascular disease, and they are hosting the program’s inaugural symposium (to be held on May 11), along with a monthly seminar series at the CVC.

“We will kick off the seminar series in the fall, where we share outside research and findings and discuss them as a group,” said Rouf. “In essence, our goal is to bring together individuals from across campus and get them working toward a similar goal.”

What started as a team of four has grown quickly to 12 faculty members from eight specialties, with new faculty membership inquiries occurring frequently.

“We’re hopeful that this will be a program that grows in size, influence and success over the years,” said Lori Isom, Ph.D., M-BRISC co-director. “And that means we’ll be creating real changes in the way cardiovascular disease is treated in the near future.”

Interested in joining M-BRISC? Email Kayla Griffey at