Heart disease in young women is estimated to increase sharply by 2050

Heart disease in young women is estimated to increase sharply by 2050

By Lauren J. Young edited by Claire Cameron

Heart disease is the leading cause of death for women in the United States; it kills more of them than all forms of cancer combined. But the unique signs and symptoms of heart disease in women are more likely to go undetected and untreated than those in men.

The dangers of heart disease for women may be getting worse, according to a new analysis. Based on national data between 2010 and 2020, researchers estimate that by 2050, the incidence of major cardiovascular disease and stroke in women in the United States will increase from 10.7 percent to 14.4 percent—affecting more than 22 million people. And that doesn’t count high blood pressure.

The study, published today in Circulation, also shows an alarming increase in disease in younger women: almost a third of all women between the ages of 20 and 44 will be diagnosed with some form of cardiovascular disease by 2050.

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The estimate is “really a wake-up call,” said Karen Joynt Maddox, lead author of the study and a cardiologist at Washington University in St. Louis. She is also vice chair of the American Heart Association’s Council on Quality of Care and Outcomes Research, which publishes these forecasts each year.

“Despite all our wonderful advances in treating cardiovascular disease, we haven’t made much progress in preventing the disease. And in fact, estimates suggest we’re doing worse and worse at preventing cardiovascular risk factors,” she says.

The estimates represent a setback in the fight against cardiovascular disease, said C. Noel Bairey Merz, a cardiologist at Cedars-Sinai Medical Center in Los Angeles, who was not involved in the study.

“We had this idea that maybe by the end of this century, cardiovascular disease would be a rare condition,” says Bairey Merz. “Until 2010, we had cardiovascular disease down to one in four women, and now we’re back to one in three. It’s a sad reality.”

Hypertension – a form of high blood pressure that is an early risk factor for heart disease – could increase, according to the projections. Almost 60 per cent of women will have high blood pressure by 2050 – up from 50 per cent in 2020. And the rates of a range of cardiovascular conditions, such as coronary heart disease, heart failure, stroke and atrial fibrillation, could all rise slightly, according to the study. By 2050, the incidence of diabetes may increase by 10 percent, while the incidence of obesity may increase by around 17 percent. Similar trends were observed in girls aged two to 19, with obesity predicted to rise from 19.6 per cent to 32 per cent by 2050.

“Cardiovascular disease is a lifelong disease. We can see risk factors starting in childhood,” says Joynt Maddox. “I worry a lot about the increase we’re projecting in young people, about setting people up to have heart problems when they’re in their 30s, 40s and 50s instead of their 60s and 70s and 80s.”

Older women have a higher incidence of disease, but cardiovascular risk factors are high and increase in younger groups. These two trends can feed each other in a vicious circle, explains Joynt Maddox. As women age, they may experience higher rates of cardiovascular disease associated with a previous heart or metabolic problem. People with a previous history of stroke and heart attack are more likely to die of heart failure years later.

Similar trends can be seen in men, says Joynt Maddox. “It’s not that women uniquely experience the increase in obesity or high blood pressure, but there are multiple layers on top of that,” she adds.

Part of the reason why women may be at particular risk may relate to the significant hormonal changes they experience throughout their lives, including during menstruation, pregnancy and menopause, says Joynt Maddox. Determining how these life events affect heart health will require more research, but these are “questions that we can definitely build on,” says Bairey Merz.

Socio-economic and demographic factors also affect the results. For example, black women have the highest rates of high blood pressure, obesity and diabetes, all of which are risk factors for cardiovascular disease, and this is expected to still be the case in 2050. They may also see the biggest jumps in heart failure and stroke, according to the new predictions.

“It’s two-fold these intersections — you’re black or brown, and you live in a rural or underserved area, and you have absolutely no access to health care or insurance,” says Bairey Merz.

These racial health differences are well documented, but the new forecast emphasizes the need for better prevention measures and health policy, says Joynt Maddox. New glucagon-like peptide 1 (GLP-1) drugs, for example, may help reduce the incidence of cardiovascular disease and obesity. How much GLP-1 drugs will do this “is a huge unanswered question,” says Joynt Maddox, adding that the data the estimates are based on does not completely overlap with the increase in GLP-1 drugs. “But I’m optimistic that it’s going to be part of helping us bend the curve.”

Editor’s note (2/26/26): This story was edited after posting to correct the age range of affected women.

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