Women of all ages face rising risks of heart disease and stroke—but cardiologists see a path forward
The number of women living with cardiovascular disease (CVD) is expected to skyrocket in the years ahead, according to a new scientific statement from the American Heart Association (AHA).
The hypertension rate among women, for example, is projected to increase from 48.6% in 2020 to 59.1% in 2050. Similar trends are expected for diabetes (14.9% to 25.3%), obesity (43.9% to 61.2%), coronary heart disease (6.85% to 8.21%), heart failure (2.45% to 3.6%), stroke (4.14% to 6.74%) and atrial fibrillation (1.58% to 2.31%).
The AHA scientific statement, published in full in Circulation, represents a collaboration of cardiologists, neurologists, healthcare policy specialists and statisticians.[1] Nearly all of its authors are women.
“Cardiovascular disease is the leading cause of death for women and remains their No. 1 health risk overall,” said cardiologist Stacey E. Rosen, MD, volunteer president of the American Heart Association, executive director of the Katz Institute for Women’s Health and senior vice president of women’s health at Northwell Health in New York City, said in a statement. “While many people may think these conditions like high blood pressure are only occurring in older women, we know this is not the case. We know the factors that contribute to heart disease and stroke begin early in life, even among young women and girls. The impact is even greater among those experiencing adverse social determinants of health such as poverty, low literacy, rural residence and other psychosocial stressors. Identifying the types of trends outlined in this report is critical to making meaningful changes that can reverse this course.”
“One in every three women will die from cardiovascular disease—maybe it’s your grandmother, or your mother or your daughter,” added cardiologist Karen E. Joynt Maddox, MD, MPH, volunteer chair of the statement’s writing group and co-director of the Center for Advancing Health Services, Policy & Economics Research at the Washington University School of Medicine in St. Louis. “Additionally, more than 62 million women in the U.S. are living with some type of cardiovascular disease and that comes with a price tag of at least $200 billion, annually. Our estimates indicate that if we stay on the current path, these numbers will grow substantially over the next 25 to 30 years.”
A growing problem for all ages
One key takeaway from the report is the fact that these increasing risks are not only issue for older women; the same trends are being seeing among younger women as well. The diabetes rate is projected to increase from 6% to 16% for women between the ages of 22 and 44, for example, and obesity and hypertension rates are also on the rise among that same population.
The scientific statement also includes troubling stats about cardiovascular risk factors in young girls. Obesity is becoming more and more prevalent among girls between the ages of 2 and 19, the group found, due to “inadequate physical activity” and “poor diets.” These rates are especially high among Black girls, mirroring what is seen among Black women.
“This trend in increased health risks among girls and young women is particularly disturbing, as it indicates they will be facing chronic health issues for most of their lives. Women are already at increased risk for so many of these health conditions due to factors unique to them throughout their lifespan,” Rosen said. “Significant health changes during pregnancy, perimenopause and menopause make it particularly important to pay close attention to increases in health risk factors during those times.”
How physicians—and patients—can help reverse these trends
The scientific statement’s authors did note that improved prevention efforts can make a world of difference. Healthy lifestyle choices should be promoted and celebrated, for example, and care teams should make it a priority to provide long-term support to women who may face an increased risk of developing CVD. In addition, more research is needed to ensure GLP-1 drugs, one of cardiology’s biggest ongoing trends, are safe and effective for women.
It also becomes essential to keep these risks in mind throughout the patient’s entire life, from childhood to retirement and beyond. And cardiologists, OB-GYNs and other physicians should be providing coordinated care before, during and after pregnancy to guide women through that life-changing process as safely as possible.
In the same statement, Rosen noted that these statistics should represent a wake-up call.
“Every woman of every age should understand her risk of heart disease and stroke and be empowered to take action to reduce that risk,” she said. “Know your numbers, listen to your body and be an advocate for your health. Additionally, support girls and women in your life to do the same. We can make a difference—we can be the difference.”
Joynt Maddox added that it is time for technology and innovation to start playing a bigger role in helping women stay healthy. While medical breakthroughs are regularly being announced in other fields, she said, less progress seems to be on display when it comes to identifying and managing cardiovascular risks among women.
“In this new era of digital health, artificial intelligence and new metabolic medication options, healthcare professionals increasingly have the tools to do this, but not yet the systems,” she said.
Click here for the full AHA scientific statement.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.