Women's Heart Health: New Guidelines Span Every Life Stage

Three new scientific papers published in the journal Circulation are calling for a paradigm shift in how women’s heart health is approached, emphasizing that cardiovascular risk must be assessed across every life stage, from adolescence through menopause and beyond. The papers are a joint effort by the American Heart Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine. They highlight the deep connections between hormonal health, mental health and well-being, heart health, and brain health, and stress that these links should be a routine part of care from a young age.

Key players include Dr. Sadiya Khan, chair of the writing group and Magerstadt Professor of Cardiovascular Epidemiology at Northwestern University’s Feinberg School of Medicine; Dr. Stacey E. Rosen, immediate past volunteer president of the American Heart Association; Dr. Esther S.H. Kim, director of the Center for Women’s Cardiovascular Health at Atrium Health; and Dr. Natalie A. Cameron and Dr. Amanda M. Perak, both of Northwestern. The experts point out that hormonal fluctuations—estrogen, estradiol, and progesterone—affect blood vessels, the brain, and heart muscle, influencing cholesterol, inflammation, blood pressure, and stress response. They also note that women are more likely to experience conditions such as microvascular coronary disease, heart failure with preserved ejection fraction, and spontaneous coronary artery dissection, which require specific diagnostic tests and greater awareness.

The publications urge clinicians to view each stage of a woman’s life as a window of opportunity: puberty and menstrual history can signal future heart risk; pregnancy acts as a stress test, with postpartum care being critical; and the years around menopause are a time to monitor numbers and make healthy changes. Mental health screening is also recommended as a routine part of care, given the bidirectional relationship between depression, anxiety, and cardiovascular health. The American Heart Association’s Go Red for Women initiative offers resources to help women protect and strengthen their heart at every stage of life. The overarching message is that it’s never too late to take action, and coordinated care—along with women advocating for themselves—is essential to reducing the more than 400,000 lives lost annually to cardiovascular disease in the U.S.