Medical Societies Set Out a Lifelong Framework for Women’s Heart Health

Four national medical societies have joined to create a framework for cardiovascular care that follows girls and women through major biological stages. Published in Circulation, the guidance aims to help clinicians identify, prevent and manage heart risks earlier and across a patient’s life, rather than treating care in separate specialties as disconnected episodes.

The framework identifies four stages: the years around a first menstrual period, generally ages 8 to 15; regular ovarian cycles, from the teens through about age 44; perimenopause, around ages 45 to 51; and postmenopause, from about age 51 onward. Pregnancy is considered at any stage.

The societies say hormonal, emotional and physical changes can affect cardiovascular health. Pregnancy may bring previously unrecognized risks to light, while early signs such as irregular or heavy periods and a first period before age 10 may warrant attention. In menopause, sleep problems and mood changes are among symptoms clinicians are encouraged to monitor.

The American Heart Association and the Centers for Disease Control say cardiovascular disease is the leading cause of death among women worldwide and causes more than 400,000 deaths annually in the United States. The AHA has projected that six in 10 U.S. women will have at least one form of cardiovascular disease by 2050.

Dr. Molly Siegel, a maternal-fetal medicine specialist, said pregnancy-related complications should be communicated to primary care doctors or cardiologists so they can be considered in future monitoring. She said the framework had not yet changed care systems, but expressed hope it would encourage collaboration across specialties and over time.