Cardiovascular disease is the leading cause of death in women, claiming more than 400,000 lives in the U.S. each year—more than breast cancer, lung cancer, and chronic lung disease combined—yet only about 4 in 10 women recognize it as their greatest health threat. On October 26, 2026, a trio of scientific papers published in the journal Circulation spelled out a new approach to women's heart health that treats risk and opportunity across every stage of life, according to a news release from the American Heart Association.
The publications are a joint effort among the Heart Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. They represent "a paradigm shift in how we look at women's cardiovascular and brain health," said Dr. Stacey E. Rosen, immediate past volunteer president of the American Heart Association, who helped write the reports.
"Women experience their healthcare across clinical specialties, but it often is fragmented or disconnected," said Dr. Sadiya Khan, chair of the writing group and the Magerstadt Professor of Cardiovascular Epidemiology at Northwestern University's Feinberg School of Medicine in Chicago. "Specifically, these reports connect the dots for clinicians, for patients, and across health domains so that care is holistic and begins in adolescence."
The reports emphasize how hormonal health affects cardiovascular health throughout a woman's life. Estrogen, estradiol, and progesterone "impact cells in blood vessels, in the brain, in heart muscle," Rosen said, affecting cholesterol levels, the stickiness of blood cells, inflammation, blood pressure, and the body's stress response. While the most common cardiovascular issue in women is the same as in men—plaque buildup that narrows arteries—women are more likely to have conditions such as microvascular coronary disease, which affects small blood vessels in the heart, or heart failure with preserved ejection fraction.
"Heart health for women doesn't start at menopause," said Dr. Amanda M. Perak, an associate professor of pediatrics and preventive medicine at Northwestern. "Puberty is a big turning point." A first period before age 10 is linked to a higher risk of heart disease later in life, and irregular periods—especially along with stubborn acne or unusual hair growth—can signal polyendocrine metabolic ovarian syndrome, previously known as polycystic ovary syndrome, or PCOS. "The goal isn't to worry teens about the chance of a heart attack, which are decades away for nearly all of them," Perak said. "It's that the teen years are when patterns get set, and it's much easier to keep good heart health than to get it back."
The reports also stress the importance of cardiovascular health before pregnancy. But 9 out of 10 women ages 20 to 44 have less-than-ideal heart health when they become pregnant. High blood pressure in pregnancy, gestational diabetes, or preterm birth are linked to higher risk of heart disease later in life, and the first year after pregnancy is "a very critical time" for monitoring those risks, said Dr. Natalie A. Cameron, an internal medicine specialist at Northwestern. Resources are available to help protect and strengthen heart health at every stage, including guidance on pregnancy and the postpartum period.
Mental health is another throughline. By age 17, girls are twice as likely as boys to be diagnosed with depression, and teens with depression are more likely to develop obesity later. The papers call for making mental health and well-being screening a routine part of a woman's care. Around menopause, women may experience increases in low-density lipoprotein, or "bad cholesterol," weight gain, and rising blood pressure. "The answer is an absolute, positive, emphatic no" to surrendering to inevitable decline, Rosen said, noting it is never too late to make healthy changes. Women can learn more about supporting heart health in midlife and during menopause and beyond.
Because women's care is often fragmented across pediatricians, primary care doctors, obstetrician-gynecologists, cardiologists, and psychologists, the new publications spell out the need for unified care. A Spanish-language version of the announcement is also available as a Spanish news release, and a companion story, Why every stage of life matters for a woman's heart health, offers further detail. A My Heart & Health Checklist - Questions to think about before your next visit is available to help women prepare for appointments. The original release can be viewed on www.newmediawire.com.
