Nearly 6 in 10 U.S. Women could have some form of cardiovascular disease (CVD) by 2050, a substantial increase driven by rising rates of high blood pressure, diabetes, and obesity, according to a scientific statement released Wednesday by the American Heart Association.
The projections, published in the journal Circulation, forecast that the percentage of women with at least one type of CVD will climb from 10.7% in 2020 to 14.4% in 2050. Cardiovascular disease is currently the leading cause of death for women in the U.S., encompassing conditions like coronary heart disease, heart failure, atrial fibrillation, and stroke.
“Here’s a call to action,” said Dr. Stacey Rosen, volunteer president of the American Heart Association and executive director of the Katz Institute for Women’s Health at Northwell Health in Fresh York City. “We have major advances in lifesaving treatments for heart disease, but this is an opportunity to rethink how to improve prevention and early detection.”
The American Heart Association’s findings are based on analysis of data from the National Health and Nutrition Examination Survey (2015-2020) and the Medical Expenditure Panel Survey (2015-2019), combined with U.S. Census Bureau population growth forecasts. The analysis projects specific increases in the prevalence of different CVD types among adult women:
- Coronary heart disease: from 6.9% in 2020 to 8.2% in 2050
- Heart failure: from 2.5% to 3.6%
- Atrial fibrillation: from 1.6% to 2.3%
Dr. Karen Joynt Maddox, a cardiologist and chair of the statement writing group, explained that the aging of the population is a contributing factor. “But rising rates of diabetes, obesity, and high blood pressure are similarly key drivers, raising the risk for heart conditions both independently and in combination,” said Joynt Maddox, who is a professor of medicine and public health at the Washington University School of Medicine in St. Louis.
The statement projects a significant increase in the prevalence of high blood pressure among adult women, from 48.6% in 2020 to 59.1% in 2050. Diabetes rates could climb from 14.9% to 25.3%, and obesity from 43.9% to 61.2%. These risk factors are increasing across all age groups, including young women aged 20 to 40. Obesity rates are also projected to rise among girls, from 19.6% to 32.0%.
“That’s setting up an entire generation of girls and young women to develop these cardiovascular diseases at a much younger age,” Joynt Maddox said.
The projections do not fully account for the growing use of GLP-1 drugs, a class of medications used for weight loss and Type 2 diabetes that have also shown potential to lower the risk of heart attacks and heart failure. Rosen acknowledged the uncertainty surrounding the long-term impact of these drugs, noting the need for continued research into their safety and efficacy. She also pointed out that access to these medications remains a barrier for many communities.
Norrina Bai Allen, an epidemiologist specializing in cardiovascular disease and director of the Institute for Public Health and Medicine at Northwestern University’s Feinberg School of Medicine, added that disparities in access to GLP-1s could widen existing cardiovascular risk gaps. “Not all communities can afford the out-of-pocket expenses for GLP-1s, and unfortunately, we may see a widening of disparities in cardiovascular risk factors and outcomes,” she said.
The American Heart Association emphasizes that women can take steps now to lower their lifetime risk of developing heart problems. Regular checkups, adherence to prescribed medications, and the adoption of healthy habits related to diet and exercise are crucial, particularly during pregnancy and menopause, when women may be more susceptible to developing diabetes and high blood pressure.
“Eighty percent of each of our risks for heart disease is preventable, and it starts with awareness,” Rosen said.