According to projections outlined in a new scientific statement from the American Heart Association, nearly 6 in 10 women in the U.S. will have some type of cardiovascular disease by 2050. The statement, published in Circulation, builds upon prior work to assess future cardiovascular disease prevalence among women and the subsequent economic burden, which currently exceeds $200 billion annually.
The rise is driven primarily by projected increases in high blood pressure, affecting nearly 60% of women compared to fewer than half currently. Significant increases are also forecast for diabetes and obesity, with more than 25% of women expected to have diabetes and over 60% projected to have obesity by 2050. These health factors contribute directly to cardiovascular conditions including heart disease, heart failure, atrial fibrillation and stroke.
Perhaps most alarming is the projected increase among younger women. Nearly a third of all women aged 22-44 will have some type of cardiovascular disease by 2050, compared to less than one in four currently. Diabetes rates for this age group are expected to more than double, from 6% to nearly 16%, while high blood pressure will affect more than a third of young women, an increase of over 11%.
The trend extends to younger generations, with nearly 32% of girls aged 2-19 projected to have obesity by 2050, an increase of more than 12%. This is likely driven by more than 60% of these girls having inadequate physical activity and more than half having poor diets, rates that are projected to improve only slightly over coming decades.
Disparities are particularly pronounced among women and girls of color. By 2050, high blood pressure will increase most among Hispanic women (up by more than 15%), while obesity will increase most among Asian women (up by nearly 26%). Prevalence rates will remain highest among Black women, with projections indicating more than 70% will have high blood pressure, more than 71% will have obesity, and nearly 28% will have diabetes.
"Cardiovascular disease is the leading cause of death for women and remains their #1 health risk overall," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "While many people may think these conditions like high blood pressure are only occurring in older women, we know this is not the case. We know the factors that contribute to heart disease and stroke begin early in life, even among young women and girls."
The report emphasizes that these projections are not inevitable. The American Heart Association defines optimal health through its Life's Essential 8™ metrics, which include four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (manage weight, control cholesterol, manage blood sugar and manage blood pressure). Research indicates that as much as 80% of heart disease and stroke can be prevented through these measures.
"Society has come so far in medical advancements, but the same can't be said for innovation and progress around cardiovascular health, wellness and prevention," said Karen E. Joynt Maddox, M.D., M.P.H., FAHA, chair of the statement writing group. "These projections emphasize how critical it is that we start focusing on how to help all people stay healthy."
The statement calls for improved prevention efforts, particularly for women of color and younger women, through health behavior promotion in schools and community centers, better management of chronic conditions, and quality improvement programs like the American Heart Association's Get With The Guidelines® for hospital care. The report also emphasizes the importance of considering social determinants of health and tailoring interventions to different life stages, from childhood through menopause and beyond.
