Heart disease is the leading cause of death for women in the United States. A new forecast from the American Heart Association predicts the number of women affected will rise sharply by 2050.
According to projections published Feb. 25 in the journal Circulation, nearly 15% of American women are expected to be living with cardiovascular disease or stroke by 2050, up from 10.7% in 2020.
Researchers say obesity, high blood pressure and diabetes are the primary drivers behind the projected surge.
Hypertension is projected to rise from about 49% of women today to more than 59% by mid century. Diabetes is expected to increase from roughly 15% to over 25%, while obesity is forecast to climb from nearly 44% to more than 61%.
Coronary heart disease is expected to increase from 6.9% of women in 2020 to 8.2% in 2050. Stroke rates are projected to rise from 4.1% to 6.7%. Heart failure and atrial fibrillation are also expected to increase steadily.
The financial impact is also significant. Between 2020 and 2021, direct and indirect spending on cardiovascular disease reached nearly 418 billion dollars.
High cholesterol rates are projected to decline, likely due to broader statin use and improved treatment strategies. Researchers caution, however, that falling cholesterol alone will not offset rising obesity and diabetes rates.
While older women will continue to carry the largest total burden of heart disease, women between 20 and 44 years old are projected to see the steepest increases in stroke, hypertension and overall cardiovascular disease.
Obesity is accumulating earlier in life. Among girls ages 2 to 19, nearly one in five is obese today. By 2050, projections suggest nearly one in three girls could be obese.
Researchers also pointed to declining age of first menstruation in American girls, now averaging 11.9 years. Early menstruation has been linked to higher cardiovascular risk later in life, partly through its association with obesity and blood sugar problems.
Black women already have the highest rates of hypertension, diabetes and stroke and are projected to see some of the steepest increases in heart failure. American Indian and Alaska Native women currently have the highest rates of coronary heart disease. Hispanic women are expected to experience significant growth in multiple risk factors over time.
Doctors say the trend is serious but can be addressed.
“This is a projection,” said Dr. Rina Mauricio, director of women’s cardiovascular health at UT Southwestern Medical Center in Dallas. “But that means that starting with your young children and yourself, you can start doing something now to prevent something that’s going to happen 10 to 20 years from now.”
Blood pressure remains the most important modifiable risk factor. “Blood pressure is the biggest modifiable risk factor for cardiovascular disease,” Dr. Karen E. Joynt Maddox of Washington University School of Medicine said in a statement.
She added that keeping track of blood pressure, blood sugar, cholesterol and body weight is “the most important thing” a woman can do for her cardiovascular health.
Doctors also recommend regular exercise, healthier diets, quitting tobacco and getting adequate sleep. Women are encouraged to speak with their physicians about risks related to pregnancy, menopause and family history. Conditions like preeclampsia during pregnancy, once considered temporary complications, are now recognized as warning signs for long term cardiovascular risk.
“You don’t wait until they’re 50,” Mauricio said, “to look for something that should have been caught when a woman was 30.”
Researchers note that reducing major risk factors by just 10% could cut cardiovascular events by up to 23%. Without earlier prevention and intervention, millions more American women could face heart disease in the coming decades.