Cardiovascular disease is the leading cause of death in women, yet less than half recognize it as their greatest health threat.
Four major medical organizations released a coordinated framework on October 26, 2026, published in the journal Circulation, to prevent, detect, and manage cardiovascular disease among girls and women.
The guidance connects care across clinical specialties to address life stages from puberty through menopause and beyond. Projections indicate that nearly six in 10 U.S. women will have some form of cardiovascular disease by 2050.
And the outlook is worsening: Nearly six in 10 U.S. women are projected to have some form of cardiovascular disease by 2050.
May Bakir, system-certified cardiologist
The American Heart Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine endorsed this shared conceptual model to optimize cardiovascular health among girls and women. The American Heart Association convened a Science Advisory Group in collaboration with the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and Society for Maternal-Fetal Medicine to develop the Female Life Stage framework.
Dr. Sadiya S. Dr. Nisha Parikh is the system director of the Women’s Heart Program at Northwell Health, and Dr. Amanda Marma Perak is a pediatric cardiologist at Lurie Children’s Hospital in Chicago and associate professor of pediatrics and preventive medicine at Northwestern.
Dr. Esther Kim directs the Center for Women’s Cardiovascular Health at Atrium Health in North Carolina, while Dr. May Bakir is a double-board-certified cardiologist and founder of InfiniteHeart Health.
Previous medical guidelines often omitted biological differences between male and female patients. Hormones such as estrogen and progesterone influence metabolism, blood pressure, and blood vessels throughout a woman’s life.
“Estrogen, progesterone, and other sex hormones affect blood vessels, metabolism, and blood pressure throughout a woman’s life,” Bakir added.
The new framework divides female health into distinct periods: perimenarche, ovarian cycling, perimenopause, and postmenopause, with the peripregnancy period acting as a modifying life stage. Dr. Sadiya S. Khan, lead author of the guidelines, said that fragmented care often leaves decades of a patient’s lifespan unmonitored.
“Over her lifetime, a woman may see a pediatrician, a gynecologist, an obstetrician, a primary care doctor, an endocrinologist, and a cardiologist,” Khan said, pointing out that divergent guidelines across specialties lead to missed warning signs.
During the ovarian cycling stage, girls and women have relative protection from atherosclerotic cardiovascular disease due to the endogenous cycling of sex hormones. However, data indicate that the incidence of myocardial infarction among women aged 35 to 54 years increased between 1995 and 2014.
The advisory outlines pregnancy as a natural stress test for the cardiovascular system. Adverse outcomes such as gestational diabetes, hypertensive disorders, preterm birth, and small for gestational age births serve as long-term risk indicators.
Adverse pregnancy outcomes such as hypertensive (high blood pressure) disorders, gestational diabetes, preterm birth, small for gestational age birth, and fetal death can all have long-term implications for heart health in women.
Sadiya S. Khan, Northwestern University Feinberg School of Medicine
“Women should share with their clinicians their pregnancy history, including any adverse pregnancy outcomes that they experienced, throughout the rest of their lives as they can have long-term impacts,” Khan told NBC 5 Dallas-Fort Worth.
Psychosocial elements, including financial strain, caregiving pressures, and mental health difficulties, are incorporated into the new risk parameters because they directly affect blood pressure and daily habits.
The new guidelines emphasize the impacts of social and emotional well-being on physical health.
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