Closing Gaps in Women’s Heart Health
Gift Advances Research into Cardiovascular Disease in Women
For years, Karin Bain Kukral (’13, ’17 P) observed a troubling reality: that women have too often been overlooked in cardiovascular research.
She knew that heart disease remains a leading threat to women’s health—and that women have historically been underrepresented in cardiac studies and can experience heart disease differently than men. Those disparities were more than a matter of public concern for Kukral; they were personal. Her mother lived with a heart condition related to rheumatic fever and ultimately died following a heart attack at age 79.
Women have long been underrepresented in modern medicine, in part because leading research institutions assumed that scientific findings for men applied equally to women. The National Institutes of Health (NIH) Revitalization Act passed in 1993 required women to be included in NIH-funded clinical research, but decades of exclusion left lasting gaps in scientific knowledge. Today, scientists know that heart disease can develop, appear, and respond to treatment differently in women, making research focused on women's heart health more important than ever.
“When I wanted to make a donation to support medical research, I chose women’s health because it has historically been under-researched,” Kukral said. “Women were not always included in studies, and we’ve learned that women often present differently than men."
That conviction led Kukral and her husband, Northwestern University Trustee John Kukral ’82 (’13, ’17 P), to make a significant investment in the new Women’s Heart Care program at Northwestern University Feinberg School of Medicine. The Kukrals’ support helps advance a growing effort, led by Priya M. Freaney, MD, assistant professor of Medicine (Cardiology), dedicated to understanding the unique cardiovascular needs of women and addressing longstanding gaps in knowledge and care.
“The Kukrals are spot on in their conclusion that women have been profoundly underrepresented in cardiovascular research for many decades. At Northwestern, we are working to close that gap by conducting research that recognizes and investigates the unique factors that shape women’s heart health,” Dr. Freaney said.
The Women’s Heart Care program represents a burgeoning hub for women’s cardiovascular health at Northwestern. Through collaborative and interdisciplinary research, innovative diagnostic tools, and personalized care, the program aims to set a new standard of how heart disease is prevented, detected, and treated in women across the lifespan.
Rethinking Risk Across a Woman’s Lifetime
Feinberg scientists affiliated with the Women’s Heart Care program are tackling questions at the intersection of cardiovascular disease and the uniquely female experiences that can shape long-term health.
One of the program’s current areas of focus is a growing body of research examining premature menopause and its relationship to heart disease. In a recent study published in JAMA Cardiology, Dr. Freaney and her team followed more than 10,000 women and found that menopause occurring before age 40 is associated with a 40 percent increase in lifetime risk of coronary heart disease. The study was the first of its kind to calculate lifetime heart risk associated with premature menopause. Now, investigators are working to better understand the biological mechanisms behind that connection, with the goal of informing earlier screening and intervention strategies for women at heightened risk.
The program is also advancing care for women in the critical months following pregnancy. Through the Mobile Health Interventions to Prevent Heart Disease after Hypertensive Disorders of Pregnancy (mHEART) study led by Dr. Freaney, scientists are investigating digital health interventions and early screening approaches designed to improve cardiovascular outcomes for mothers who experience high- risk hypertensive pregnancies. By focusing on postpartum care, the initiative seeks to address cardiovascular risks that can emerge well beyond delivery and often go unrecognized until later in life.
Sarah A. Goldstein, MD, leads the Heart Disease and Pregnancy Program and serves as an assistant professor of Medicine (Cardiology). Paying close attention to the physiological demands of pregnancy may help treat existing heart conditions and provide clues about new ones that may arise, she said.
“Pregnancy is a significant stress test for the heart—a nine-month marathon for the cardiovascular system. Our Women’s Heart Care program helps patients understand their risk and provides interventions to reduce it,” Dr. Goldstein said.
Looking ahead, investigators plan to expand their efforts into several emerging areas of women’s cardiovascular health, particularly in midlife. Sadiya S. Khan, MD, MSc, the Magerstadt Professor of Cardiovascular Epidemiology, is working on a first-in-kind initiative to support clinician education among primary care clinicians, obstetricians and gynecologists, and preventive cardiologists to recognize increased risk of cardiovascular disease in women. This study will focus on high-risk windows for women when engagement with the healthcare system is also high: the menopausal period. Dr. Khan is an associate professor of Medicine (Cardiology) and of Medical Social Sciences and Preventive Medicine and director of the Center for Population Science and Aging.
A Family History of Women in Medicine
For Karin Kukral, supporting research and education are a core part of her value system, which she traces back generations. Her grandfather, who immigrated to the U.S. from Greece, insisted that all four of his daughters receive a college education—an uncommon opportunity for women of that era. Many members of her family subsequently entered healthcare professions, including her mother, an occupational therapist, as well as relatives who became a hematologist, dietitian, and dentist.
“Education is one of those things that you can never lose,” she said, describing her family’s generational commitment to learning. Research improves societies and ultimately saves lives, she added.
Through discussions with Northwestern representatives, Kukral sought a way to direct her giving toward areas where she felt it could make a tangible difference. Now, through their philanthropy, the Kukrals are helping propel research that will help chart the course for women’s health for generations to come.
“Women’s heart health should have been studied a long time ago, but it wasn’t,” she said. “Thankfully, Northwestern is giving it the priority it deserves.”
The Kukrals have also made substantial gifts to the Family Medicine Scholarship and to the Family Medicine Transition to Residency Curriculum, affirming their commitment to medical advancement for all.
For more information about supporting women’s heart care, please contact Kathleen Praznowski at 312-503-0762 or kathleen.praznowski@northwestern.edu.