A primer on incorporating sex as a biological variable into the conduct and reporting of basic and clinical research studies

Abstract

The recent move to require sex as a biological variable (SABV), which includes gender, into the reporting of research published by the American Journal of Physiology-Heart and Circulatory Physiology follows a growing, and much-needed, trend by journals. Understandably, there is concern over how to do this without adding considerable work, especially if one's primary research focus is not on elucidating sex/gender differences. The purpose of this article is to provide additional guidance and examples on how to incorporate SABV into the conduct and reporting of basic and clinical research. Using examples from our research, which includes both studies focused and not focused on sex/gender differences, we offer suggestions for how to incorporate SABV into basic and clinical research studies.

Keywords: cardiovascular; gender; heart failure; sex; study design.

Figure 1.

Considerations for incorporating sex as a biological variable into basic and clinical cardiovascular research. There are differences in sex chromosomes, which dictate sex-based differences in physiology. In turn, sex-based differences in physiology can dictate sex/gender-based behaviors. Notably, this relationship is bidirectional such that sex/gender-based behaviors can influence sex-based physiology (noted with arrows). Collectively, sex chromosome, physiology, and behaviors all impact cardiovascular health with some differences and similarities between women/female and men/male. Although the terminology is still being debated, the important thing is to make sure that both sides are considered when conducting and reporting research, especially in augmenting our understanding of the left sides of these diagrams.