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A new forecast on women’s heart health offers many causes for concern – but also highlights how women can take charge of their future, experts say.

The forecast comes in a from the ·¬ÇÑÊÓƵ, published Feb. 25 in the journal Circulation. that by 2050:

• more than 59% of women in the U.S. will have high blood pressure, up from less than 49% today.


• more than 25% of women will have diabetes, up from about 15%.


• more than 61% of women will have obesity, up from about 44%.


• as those risk factors become more common, the overall prevalence of cardiovascular disease and stroke in women will rise to 14.4% from 10.7%.

Not all the trends are negative. The prevalence of women with unhealthy cholesterol levels is projected to decline to about 22%, down from more than 42% today.

Knowledge of these trends, while concerning, might also be empowering, said Dr. Rina Mauricio, director of women's cardiovascular health at UT Southwestern Medical Center in Dallas.

“This is a projection,” said Mauricio, who helped write the report. “But that means that starting with your young children and yourself, you can start doing something now to prevent something that’s going to happen 10 to 20 years from now.”

What’s behind the trends in women’s cardiovascular health?

Cardiovascular disease is the leading cause of death for women in the United States and globally. The term covers many conditions, including coronary heart disease (plaque in the arteries that can lead to heart attack or stroke), heart failure and irregular heartbeats.

While the new report did not calculate projections for men, it follows a that forecast similar trends in cardiovascular disease among the broader population. Two main factors underline the increases the report predicts in women, said Dr. Karen E. Joynt Maddox, a professor at the Washington University School of Medicine and School of Public Health in St. Louis. Joynt Maddox led the committees that wrote both statements.

The first underlying factor is demographics. “The population is aging,” she said. “The baby boomers are hitting their 60s and 70s, the age where cardiovascular disease tends to occur, and people are living longer.” Women in particular tend to live longer and to develop cardiovascular disease later in life, she said.

At the same time, the risk factors that drive cardiovascular disease are on the rise.

Some factors are improving. Better screening and changes in diet are helping with cholesterol management, Mauricio said. And the statement notes that levels of smoking, inadequate physical activity and less-than-ideal diet are expected to improve. (Because of the way the data are gathered and analyzed, it’s not clear why obesity levels are projected to rise so much despite that, Joynt Maddox said.)

What are some particular areas of concern for women and girls?

The expected increase in obesity overall is troubling, Mauricio said, particularly in girls. By 2050, almost a third of girls ages 2-19 are projected to be obese. “That to me is incredibly worrisome,” she said.

And because that obesity can lead to high blood pressure and diabetes, “we will see a rise in heart disease risk factors that may result in even higher rates of cardiovascular disease down the line,” Mauricio said.

The scientific statement notes that diabetes “is a particularly potent risk factor for women,” putting them at higher risk for a range of cardiovascular conditions compared with men, including heart failure, stroke and coronary heart disease (the buildup of plaque in the arteries that can lead to a heart attack or stroke.)

The statement also details the differences in risks among white, Black, Hispanic, American Indian/Alaska Native and Asian women. “There are major issues with access to care and other gaps that are worse among people from racial and ethnic minority groups and people in rural areas,” Joynt Maddox said.

She also noted that women are more likely than men to have a stroke; a type of irregular heartbeat called atrial fibrillation; and a type of heart failure that is related to stiffness of the heart instead of blockages in the coronary arteries.

What can women and girls do to buck the trends in cardiovascular disease?

You might not know you have high blood pressure, Joynt Maddox said, because it might not cause any symptoms. “But your blood vessels know,” she said. “And as you get older, if your blood pressure has been uncontrolled, then the damage is there.”

So acting now can pay off down the road. Suggestions she and Mauricio made on how to lower risks include:

• Know your numbers for blood pressure, blood sugar and blood cholesterol and body weight. Joynt Maddox called this “the most important thing” a woman can do to protect her cardiovascular health.
  
  

  High blood pressure raises the risk of heart attack and stroke, but it can be treated, and “is the single biggest modifiable risk factor for cardiovascular disease,” she said.

• Be aware that risk factors for cardiovascular disease develop early but “are very much within the hands of our patients to do something about,” Mauricio said. The basics are outlined in the Association’s Life’s Essential 8, which includes behaviors such as eating better, being more active, quitting tobacco and getting healthy amounts of sleep.


• If you’re feeling overwhelmed and don’t know where to start, Mauricio suggested choosing just one thing and focusing on that. “If you want to make sustainable change, you can’t do it all at once because you’re going to burn out,” she said.

So commit to moving more, or to changing one meal of your day consistently, she said, but “don’t try to do both.” If you decide that you're going to focus on physical activity, “then you are going to get your daughter, and when you are both home from school and work, you’re going to walk for 30 minutes. And you’re going to do that together and you're going to do it two days a week, then three days a week, then five days a week.”

If your goal is to find healthier ways to eat, sit down with your daughter, plan your grocery shopping and come up with a plan for breakfasts you can enjoy together.

“I don’t expect any of my patients to make sustainable change by the time they come back and see me in three months,” Mauricio said. But she said improvement can come “one change at a time.”

What should women be discussing with their doctors?

Women should make sure their health care team is regularly checking cholesterol, blood pressure and blood sugar levels, Mauricio said. They should also bring up issues that are not part of routine screenings.

“We know that there are some sex-specific risk factors for heart disease,” she said, so during an exam, it’s worth mentioning, “‘by the way, I underwent menopause really early because I had a hysterectomy.’ That’s important. Or, ‘Hey, I had high blood pressure and diabetes during pregnancy.’”

Practitioners need to remember that heart disease is happening in women earlier, Mauricio said. That means screening young women for high blood pressure and asking whether they’ve been screened for cholesterol issues, too. “You don't wait until they’re 50,” she said, to look for something that should have been caught when a woman was 30.

Go Red for Women is an ·¬ÇÑÊÓƵ initiative designed to empower women to take charge of their heart health. Find links to resources and helpful advice on maintaining or improving heart health at .