If prevention and early detection do not improve, the number of women with cardiovascular diseases will increase substantially in the coming decades, the American Heart Association warned this Wednesday.
The entity predicted that the percentage of women with at least one type of cardiovascular disease will increase by more than a third, going from 10.7% in 2020 to 14.4% in 2050.
The forecasts were made based on historical trends from two national health surveys and Census estimates of population growth.
Cardiovascular diseases are already the leading cause of death among women in the United States.
The most common form is coronary heart disease, which occurs when fatty deposits called “plaque” build up in the arteries of the heart, preventing them from supplying oxygen-rich blood to the heart muscle.
Other types included in the new report are heart failure, when the heart has difficulty filling and pumping blood; atrial fibrillation, a type of abnormal heart rhythm; and stroke.
The experts’ forecasts are “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 New York City. Each year, the association produces scientific reports and guidelines based on expert consensus to promote a longer and healthier life.
There have been significant advances in life-saving treatments for heart disease. But this is an opportunity to rethink how to improve prevention and early detection, Rosen said.
The statement’s authors analyzed several years of data collected in two national surveys. One was the National Health and Nutrition Examination Survey, from 2015 to 2020, which asks adults and children about their health and diet.
The other was the 2015 to 2019 Medical Expenditure Panel Survey, an annual government survey that asks a broad sample of individuals and families, their medical providers, and their employers about the cost and use of health care and health insurance coverage.
The authors used Census projections of population growth to extrapolate those historical trends into the future.
Among adult women, the rate of cardiovascular disease is expected to increase from:
- 6.9% in 2020 to 8.2% in 2050 in terms of coronary heart diseases.
- 2.5% to 3.6% for heart failure.
- 4.1% to 6.7% for strokes.
- 1.6% to 2.3% regarding atrial fibrillation.
An aging population is one of the factors driving these increases, explained Dr. Karen Joynt Maddox, a cardiologist and president of the group that wrote the paper. Joynt Maddox is a professor of medicine and public health at Washington University School of Medicine in St. Louis.
Risk factors among young women
Rising rates of diabetes, obesity, and high blood pressure are also factors that, together and independently, increase the risk of heart disease.
If current trends continue, the prevalence of high blood pressure among adult women is projected to increase from 48.6% in 2020 to 59.1% in 2050.
Diabetes rates could increase from 14.9% to 25.3% and obesity rates from 43.9% to 61.2%, according to the statement.
These cardiovascular risk factors are increasing in all age groups, including young women between 20 and 40 years old. The obesity rate is also expected to increase among girls, from 19.6% to 32.0%.
“This is predisposing an entire generation of girls and young women to developing these cardiovascular diseases at a much younger age,” Joynt Maddox said.
According to questions in one of the surveys, the percentage of women who eat poorly or do not exercise enough is expected to decrease slightly, and smoking is expected to continue to decline. However, the proportion of women with sleep problems will increase.
Most adverse trends are expected to be most pronounced among girls and women who identify as Black, Hispanic, Indigenous, or multiracial.
The impact of slimming drugs
The study did not take into account the increasing use of GLP-1 drugs, powerful drugs for weight loss and treating type 2 diabetes. Research has also shown that these drugs can help reduce the risk of repeat heart attacks and recurrent episodes of heart failure, Rosen said.
Its impact 30 years from now on cardiovascular disease and its risk factors, such as obesity and diabetes, is uncertain, Rosen added, adding that “long-term safety is something that needs to be further studied.”
Research has also shown that many people stop using medications because of unpleasant side effects and then regain much of the weight they lost.
There are other obstacles to weight loss medications.
“Not all communities can afford the out-of-pocket costs of GLP-1, and unfortunately, we may see increasing disparities in cardiovascular risk factors and outcomes,” said Norrina Bai Allen, a cardiovascular disease epidemiologist and director of the Institute for Public Health and Medicine at Northwestern University Feinberg School of Medicine.
In the meantime, women can work now to reduce their risk of developing heart problems later in life, Joynt Maddox said.
It’s essential to get regular checkups, take prescribed medications, and develop healthy diet and exercise habits, especially during pregnancy, when diabetes and high blood pressure may first appear, and during menopause, when cholesterol, blood pressure, and sleep change.
It’s never too late or too early to start. “Eighty percent of each of our heart disease risks are preventable, and it all starts with awareness,” Rosen added.
