- Four medical organizations have published a trio of reports aimed at improving female heart health.
- The recommendations include a comprehensive plan to prevent and manage cardiovascular disease across all stages of the female life span.
- The organizations say that females have unique biological components that can make their risk of heart disease higher than that of males.
A quartet of medical organizations has published a comprehensive set of reports calling for a coordinated plan of action to improve heart healthcare for women throughout their lifetimes.
The reports detail how cardiovascular health issues can be prevented, monitored, and treated from the early years of menstruation to peak fertility age to pregnancy to perimenopause to postmenopause stages.
The report authors call for healthcare professionals to identify heart health risks early in girls and women and to coordinate care across medical specialties.
They stress that females have specific biological factors that increase their risks of cardiovascular disease. Those components include hormonal and emotional factors.
The authors note that heart disease is the number one cause of death for females in the United States, as well as the number one cause of death during pregnancy. Yet, only 44% of females are fully aware of the dangers they face from heart disease.
The organizations issuing the reports are the American Heart Association (AHA), the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine.
The groups presented their findings in a trio of reports published in the AHA’s flagship journal,
“Women experience their healthcare across clinical specialties, but it often is fragmented or disconnected,” said Sadiya Khan, MD, the chair of the collaborative writing group for the reports and a professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine in Chicago, in a
“Specifically, these reports connect the dots for clinicians, for patients, and across health domains so that care is holistic and begins in adolescence, recognizing that women’s heart health is uniquely shaped by biological transitions not experienced by men — periods, pregnancy, perimenopause, and menopause.”
Experts not involved in the reports told Healthline the updates were a long time coming.
Nicole Weinberg, MD, a cardiologist at Pacific Heart Institute’s Women’s Heart Center in Santa Monica, California, said the reports present a positive framework for women’s health.
“Women have unique cardiovascular risk factors related to pregnancy and menopause, and certain traditional risk factors, including diabetes, may increase their risk of heart disease more significantly than they do in men,” noted Nissi Suppogu, MD, a cardiologist and medical director of the Women’s Heart Center at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in California.
“Recognizing these differences is essential to identifying women at risk earlier, improving prevention strategies and ensuring they receive appropriate treatment,” she said.
“I am incredibly excited to see these new reports on women’s heart health,” added
“They are a call to action for increasing education, research, and coordinated clinical care for women’s heart health,” Shah said.
The organizations spelled out their recommendations in three reports.
The first report is a
In it, the authors state that “girls and women uniquely experience fragmented care” across medical fields, including pediatrics, obstetrics, and gynecology.
The authors call for a “unified life course approach that addresses the female-specific interconnectedness of hormonal, psychosocial, and cardiovascular health.”
This report breaks down the life cycle for girls and women into five stages.
- Perimenarche: The transition around the first menstrual period. Age range of 8 to 15 years.
- Ovarian cycling: Regular ovarian and hormone cycles are established, and pregnancy typically occurs. Age range: 15 to 44 years.
- Perimenopause: The transition to variable cycle length, skipped cycles, and hormone changes. The estimated age range is around 45 to 51 years.
- Postmenopause: The years that begin after menopause or 12 months after the final menstrual period. Age range is 51 years and older.
- Pregnancy: The time before, during, and after pregnancy.
“Emerging data suggest that unique biologic transitions or life stages experienced by girls and women are linked with changes in [cardiovascular disease] risk, which may be due in part to physiologic changes in sex hormones,” the authors wrote.
Weinberg said this life-stage breakdown is important, especially for risk reduction.
She said issues with menstruation during the teen years may be a harbinger of heart health problems later in life. The same is true for health issues during pregnancy, especially high blood pressure or high blood sugar levels.
“We need to be aware of these heart disease risks so we’re not caught by surprise 10 to 20 years down the road,” Weinberg said.
Suppogu agreed. “Medical professionals should emphasize that heart health is a lifelong priority and prevention should begin early. Encourage girls and women to establish healthy habits, understand their cardiovascular risk factors, and maintain regular checkups, even when they feel healthy.”
“Women’s heart health has a unique constellation of risk factors and manifestations that are shaped by biological transitions that vary across a woman’s lifetime,” said Shah.
The second report is a
In it, the authors call for a system that “integrates assessment of hormonal, psychosocial, and cardiovascular health across life stages.”
They propose a “national infrastructure” of centers that would coordinate clinical care, education, training, research, and community engagement around women’s heart health.
“These centers can reduce fragmentation, enhance earlier risk identification, and expand opportunities to increase representation of women in clinical research,” the authors wrote. “In doing so, they offer a bold opportunity for a scalable and equitable model to improve cardiovascular health for all women.”
To illustrate their point, the authors noted that only about 60% of women with hypertensive disorders during pregnancy in the United States have a follow-up visit with a healthcare professional about their condition within the first 6 months after giving birth.
“Given that pregnancy is a cardiovascular stress test and hypertensive disorders of pregnancy are risk-enhancing factors for long-term [cardiovascular disease] risk, this represents a major missed opportunity to address cardiovascular risk,” the authors wrote.
“Pregnancy and the postpartum period are important windows into cardiovascular health throughout the life course,” said William Grobman, MD, the vice-chair of the writing group for these reports and a professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University in Providence, Rhode Island, in the press release.
“An adverse pregnancy outcome can unmask increased cardiovascular risk, and that information should guide care well beyond pregnancy,” he continued.
The third report is a
In it, the authors state that there is “growing recognition that the optimal prevention and management of cardiovascular disease in girls and women requires attention to sex-specific considerations relevant to the interconnected domains of hormonal, psychosocial, and cardiovascular health across the life course.”
The authors note several age-related warning signs of heart issues. These are spelled out in the AHA
- Menstrual cycle patterns can be markers of heart health, including an early warning sign for cardiovascular risk, such as polyendocrine metabolic ovarian syndrome (PMOS).
- Pregnancy history is heart history, as pregnancy complications such as high blood pressure and preeclampsia can be recognized as female-specific heart health risk enhancers.
- Perimenopause can be a cardiovascular inflection point due to changes in cholesterol and metabolic health.
- Postmenopause is an important time for cardiovascular disease prevention, as most heart attack, stroke, and heart failure events in women occur in this stage.
- Psychosocial health is important for heart health, as women are more likely to experience anxiety, depression, and eating disorders, each of which can contribute to poor heart health.
Females comprise around half the population, and their cardiovascular health “must be a part of everyday care across medicine,” said
The organization also predicted that 25% of U.S. women will have diabetes and 60% will have obesity by that year if current trends continue.
The authors of that report listed several steps they said could reverse these trends. Among them:
- Healthy choices should be provided in schools, community centers, pediatric clinics, and gynecology offices.
- Health providers should prioritize long-term plans for managing chronic conditions in women, such as high blood pressure.
- Treatment plans for long-term conditions such as atrial fibrillation (AFib) and heart failure should include factors unique to females.
Experts say women can also take action on their own to reduce their risks. Suppogu suggests the following:
- Follow a heart-healthy Mediterranean-style diet
- Get at least 150 minutes of moderate-intensity exercise each week
- Maintain a healthy weight
- Manage blood pressure and blood glucose
- Monitor cholesterol levels
- Avoid smoking
- Get at least 7 to 8 hours of sleep each night
These recommendations can also be found in the AHA’s
“Most importantly, we need to educate women that heart disease is not inevitable, and early intervention can help prevent it and improve long-term health,” Suppogu said.
Weinberg advised women to include plenty of fruits and vegetables and a minimal amount of meat in their daily diet. She said that women should have regular check-ups with their doctor, and that adopting a healthy lifestyle doesn’t have to be complicated.
Khan said women’s health is a community effort. “All girls and women deserve more healthy years to live their fullest lives,” she said in the press release.
“Advancing women’s health is a responsibility we all share. This investment improves not only women’s health but also the health of their families and their communities.”
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