Female-Specific Treatments for Microvascular Dysfunction
Researchers at UNSW Sydney are spearheading a trial to develop female-specific treatments for coronary microvascular dysfunction (CMD), a condition affecting post-menopausal women’s heart health.
Associate Professor Erin Howden from UNSW Medicine & Health leads the project, supported by Wellcome Leap’s VISIBLE program, which invests over AUD 75 million in women’s cardiovascular health.
CMD, often described as invisible heart disease, impacts the heart’s tiny blood vessels and is not detectable with standard angiograms. This condition is more prevalent in women and poses significant health risks.
A/Prof. Howden explained, “Up to 70% of women with chest pain who undergo angiography are told their arteries are clear, yet many will continue to live with debilitating angina, breathlessness and fatigue that limits daily life.”
RESTORE Trial Aims for Innovative Solutions
The RESTORE trial will assess whether transdermal oestrogen and structured exercise can improve the function of the heart’s microcirculation in 132 post-menopausal women in Sydney, Melbourne, and Adelaide.
These treatments aim to address oestrogen deficiency and enhance heart vessel function, potentially leading to the first treatment targeting CMD’s underlying biology.
A/Prof. Howden noted the importance of the trial, saying, “It would also change the way CMD is understood and treated from a condition often dismissed as ‘nothing serious’, to one that can be actively managed.”
The Wellcome Leap’s VISIBLE programme focuses on improving CMD diagnosis and treatment, aiming to increase accurate diagnoses of women with stable angina and effective treatment, while ensuring reliable detection of coronary artery disease.
Professor Cheryl Jones, Dean of UNSW Medicine & Health, praised the initiative, stating, “CMD has too often gone unrecognised and undertreated in women. The RESTORE trial has the potential to transform care for millions of women worldwide.”
CMD remains poorly understood and inadequately treated. The condition can have a huge impact on women’s day-to-day lives. Many women experience debilitating symptoms and carry an up to four-fold higher risk of major cardiovascular events. CMD can limit a woman’s ability to work, often leading to reduced hours or early retirement. It negatively affects mental health and social lives.
Currently, no treatments target the underlying biology of CMD. The trial will investigate whether treating oestrogen deficiency in post-menopausal women, combined with structured exercise, can improve the function of the heart’s smallest blood vessels. Advanced cardiac MRI will be used to measure the effect on the smallest heart vessels over the 16-week trial.
