Four major medical organizations have released a shared framework for heart health in girls and women, aiming to catch risk earlier and close gaps in care that have left cardiovascular disease as the leading cause of death among women in the United States. The American Heart Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine published the framework on October 26, 2026, in three manuscripts in the journal Circulation.
Cardiovascular disease, which includes heart disease and stroke, claims more than 400,000 lives among women in the United States each year, according to the association. That total is more than breast cancer, lung cancer and chronic lung disease combined. Only about 41 percent of women recognize cardiovascular disease as their greatest health threat, the association said.
Progress in preventing cardiovascular deaths among women has stalled over the past two decades, the groups said. A 2026 scientific statement from the association forecast that, if trends continue through 2050, the share of American women aged 20 and older living with high blood pressure will rise from about 49 percent in 2020 to 59 percent in 2050.
The new framework treats cardiovascular health as a lifelong process rather than a concern that begins in older age. “Heart disease and other forms of cardiovascular disease don’t suddenly become relevant when we become older women,” said Dr. Stacey E. Rosen, a former volunteer president of the American Heart Association who helped write the three papers. Rosen described the guidance as a shift in how clinicians look at women’s cardiovascular and brain health.
Heart risk across four female life stages
The framework divides a woman’s life into four stages, each defined by a hormonal transition. Perimenarche covers the transition around the first menstrual period, at about ages 8 to 15. Ovarian cycling spans about ages 15 to 44, when regular ovulatory and hormone cycles are established and pregnancy typically occurs. Perimenopause covers about ages 45 to 51, marked by variable cycle length, skipped cycles and shifting hormones. Postmenopause begins after menopause, defined as 12 months after the final menstrual period, at about age 51 and older.
Within each stage, the framework considers cardiovascular, hormonal and emotional health together. Dr. Sadiya S. Khan, chair of the collaborative writing group and a professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine, said women’s cardiovascular health is shaped by biological transitions men do not experience, including periods, pregnancy, perimenopause and menopause. “Specifically, these reports connect the dots for clinicians, for patients and across health domains so that care is holistic and begins in adolescence,” Khan said.
Pregnancy is treated as an event that can occur at any stage and can reveal cardiovascular risk that had gone unrecognized. “Pregnancy and the postpartum period are important windows into cardiovascular health throughout the life course,” said Dr. William A. Grobman, vice-chair of the writing group and a professor of obstetrics and gynecology at Brown University. “An adverse pregnancy outcome can unmask increased cardiovascular risk and that information should guide care well beyond pregnancy,” Grobman said.
Heart care fragmented across specialties
“Women experience their healthcare across clinical specialties, but it often is fragmented or disconnected,” Khan said. The three papers give clinicians in different specialties a shared set of stages and language, so a risk factor noted in adolescence or during pregnancy can still shape care years later.
Heart risk tools and centers of excellence
The three manuscripts were prepared by a volunteer writing group on behalf of the four organizations. The association said its scientific statements outline what is currently known about a topic and what areas need more research, while its guidelines provide its official clinical practice recommendations. The framework papers are published in Circulation, and the association has posted a compendium on cardiovascular health in girls and women for clinicians and patients.