Women-related cardiovascular research funding under Canada’s Sex- and Gender-Based Analysis policy from 2000 to 2024: an interrupted time series analysis

Abstract Background Cardiovascular disease is the leading cause of death among women, yet women have historically been underrepresented in cardiovascular research. In Canada, sex- and gender-based analysis (SGBA) policies were introduced to address these gaps, including mandatory applicant-level requirements in 2010 and reviewer-level guidance in 2018. How these policies have influenced funding allocation for women-related cardiovascular research remains unclear. Objective To examine long-term trends in CIHR investment in women-related cardiovascular research and assess changes associated with SGBA policy milestones. Methods We conducted a longitudinal study using Canadian Institutes of Health Research (CIHR) funding data from fiscal year 2000-2001 to 2024-2025. Women-related cardiovascular research projects were identified through terminology searches in funded project titles, keywords, and abstracts. Annual fiscal-year proportions of cardiovascular research funding allocated to women-related research were analysed using segmented regression, with interruption points in 2010 and 2018. Results Among 17,168 cardiovascular research related grant annual records, 11.33% were classified as women-related projects. These projects accounted for 11.85% of total CIHR cardiovascular research funding over the 25-year period. Funding increased before 2010, declined between 2011 and 2017, and accelerated after 2018. Segmented regression showed a small immediate increase in 2010, followed by a negative post-2010 trend and a significant positive quadratic trend after 2018. Conclusions Application-level SGBA requirements had limited influence on investment patterns, whereas the 2018 reviewer-level guidance aligns with the subsequent acceleration in women-related cardiovascular research funding. Strengthening SGBA implementation, expanding targeted funding opportunities, and improving monitoring of sex-and-gender-disaggregated outputs may help address persistent gaps in women-related cardiovascular research.