A new scientific statement from the American Heart Association projects that nearly 6 in 10 women in the United States will have some type of cardiovascular disease by 2050, representing a significant increase from current rates. The statement, published in Circulation, builds upon prior work to assess future cardiovascular disease prevalence among women and the associated economic burden. According to the projections, driven primarily by rising rates of high blood pressure, diabetes, and obesity, cardiovascular disease will affect a growing proportion of women across all age groups and racial backgrounds.
The report, titled Forecasting the Burden of Cardiovascular Disease and Stroke in the United States Through 2050 in Women: A Scientific Statement From the American Heart Association, indicates that by 2050, nearly 60% of women will have high blood pressure, compared to fewer than half currently. More than 25% of women will have diabetes, up from about 15%, and over 60% will have obesity, compared to about 44% currently. These health factors are major contributors to cardiovascular conditions like heart disease, heart failure, atrial fibrillation, and stroke, all of which are projected to rise substantially.
One of the most concerning trends highlighted is the increasing prevalence among younger women and girls. By 2025, nearly a third of all women aged 22-44 will have some type of cardiovascular disease, compared to less than one in four currently. Diabetes rates for this age group are projected to more than double, from 6% to nearly 16%. Furthermore, the report projects that by 2050, nearly 32% of girls aged 2-19 will have obesity, an increase of more than 12%, with rates likely driven by inadequate physical activity and poor diets. Karen E. Joynt Maddox, M.D., M.P.H., FAHA, volunteer chair of the statement writing group, noted that the increases are even more prevalent among women and girls identifying as American Indian/Alaska Native, Black, Hispanic, or multiracial.
Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association, emphasized that cardiovascular disease is the leading cause of death for women and remains their number one health risk overall. She stated that while many may think conditions like high blood pressure only occur in older women, the factors contributing to heart disease and stroke begin early in life. The impact is greater among those experiencing adverse social determinants of health such as poverty, low literacy, rural residence, and other psychosocial stressors. Identifying these trends is critical to making meaningful changes that can reverse this course.
The report also outlines specific projections among women of color, indicating some of the largest increases. By 2050, high blood pressure will increase the most among Hispanic women, up by more than 15%, while obesity will increase the most among Asian women, up by nearly 26%. Prevalence rates will, for the most part, remain highest among Black women, with more than 70% projected to have high blood pressure, more than 71% to have obesity, and nearly 28% to have diabetes.
Despite the concerning projections, the report offers a positive outlook in some areas. Rates of high cholesterol are expected to decline among nearly all groups of women, and improvements are expected in some health behaviors, including healthier eating, more physical activity, and less smoking. The American Heart Association defines optimal health through its Life’s Essential 8™, which includes four health behaviors and four health factors. Rosen noted that as much as 80% of heart disease and stroke can be prevented, and Life’s Essential 8 provides tailored guidance for different times in a woman's life.
The statement serves as a call to action, emphasizing that the most efficient and least costly way to reduce cardiovascular disease is through prevention. It identifies several considerations to improve prevention, treatment, and sustained care across the life course for all women. These include promoting healthy choices in various settings, using digital tools to encourage positive lifestyle changes, prioritizing long-term support for managing chronic conditions, ensuring optimal care for clinical cardiovascular disease, and integrating care across every stage of life. The report also stresses the importance of understanding the role of social and demographic factors, noting that programs tailored for Black women are urgently needed.
Joynt Maddox, who also authored a related 2024 presidential advisory, highlighted that simulation studies show current trends are not set in stone. A 10% reduction in health factors like high blood pressure and a 20% improvement in their control could reduce cardiovascular disease and stroke events by 17% to 23%. Reducing obesity by half and doubling risk factor control could reduce events and deaths by 30% to 40%. She emphasized that in this new era of digital health and artificial intelligence, healthcare professionals have tools to address these issues but need better systems. Rosen concluded that at a time when awareness about cardiovascular disease among women has been declining, this report should be a wake-up call for every woman to understand her risk and take action.
