Women’s Heart Health Framework Ties Risk to Four Life Stages
Four leading medical societies released a joint women’s heart health framework on Monday that links cardiovascular risk to four stages of a female life, from puberty through menopause and beyond. The American Heart Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine published three papers in the AHA’s journal Circulation on Oct. 26. The groups described them as the first coordinated, multi-society effort to prevent, detect and manage cardiovascular disease in girls and women.
The “Female Life Stage” framework is built around hormonal change. Stage 1, perimenarche, covers roughly ages 8 to 15. Stage 2, ovarian cycling, runs from about 15 to 44. Stage 3, perimenopause, spans roughly 45 to 51, and stage 4, postmenopause, begins around 51. Pregnancy can occur in any stage, and societies describe the time before, during and after it as a biological “stress test” that can expose risks no one had noticed.
Within each stage, clinicians are asked to weigh cardiovascular, hormonal and emotional health together. The groups also call for a national network of Comprehensive Centers of Excellence for Women’s Cardiovascular Care, built on four pillars: interdisciplinary clinical care, professional education and training, research, and community engagement.
The AHA says cardiovascular disease is the leading cause of death among women in the US, killing more than 400,000 a year, more than breast cancer, lung cancer and chronic lung disease combined. Only about 41% of women see it as their greatest health threat. An AHA scientific statement projects that if current trends continue, the share of US women aged 20 and older with high blood pressure will climb from about 49% in 2020 to 59% in 2050.
Cardiovascular conditions also account for more than one-third of US maternal deaths, the AHA says. Sadiya S. Khan, M.D., who chaired the writing group and is a professor at Northwestern University’s Feinberg School of Medicine, said the approach gives clinicians in different specialties shared guidance to “recognize risk earlier.”
The papers call for a coordinated clinical, research and public health agenda to put the framework into practice. The release sets no timeline for the proposed centers of excellence.