AHA Urges Early Heart Disease Prevention for Women

The American Heart Association (AHA) is calling for earlier and more comprehensive heart disease prevention among women, highlighting how hormonal changes, reproductive health and mental well-being can influence cardiovascular risks throughout different stages of life.

Three new scientific publications from the American Heart Association (AHA) say it is never too late to start preventing heart disease in women, it should start from adolescence. These reports, published in Circulation, focus on the influence of reproductive health, hormonal changes and mental well-being on cardiovascular health during various phases of a woman's life.

The recommendations are released as heart disease rates are climbing for women between the ages of 20 and 54. Heart disease and stroke are the number one killer of women in the U.S. and responsible for over 400,000 deaths each year. But only approximately one out of 10 women says cardiovascular disease is their biggest health risk, the AHA reports.

The publications focus on the need for early warning indications and an understanding of reproductive health history and the adoption of preventive healthcare measures long before big hormonal changes.

Key Highlights

• Early menstrual changes may indicate future cardiovascular health risks
• Pregnancy complications can reveal underlying risks of heart disease
• Menopause-related hormonal shifts influence cholesterol and blood pressure

Both reports highlight puberty and menstrual health as key areas for long-term cardiac health. Girls that get their first period before the age of 10 could be at increased risk of developing heart disease later in life. If the menstrual periods have been irregular for a long time, especially if they are irregular and you also have acne or excessive facial hair, you may have a hormone imbalance called polycystic ovary syndrome (PCOS), which is linked to diabetes and cardiovascular risk factors.

The publications also draw attention to the effect of depression, anxiety and eating disorders in the adolescent years on lifestyle behaviours and future cardiovascular health. Early identification of these concerns may help health care providers identify women who might need more attention.

A second critical time to look for possible cardiac risk factors is during pregnancy. High blood pressure in pregnancy, gestational diabetes, and premature delivery are linked to a greater risk for heart disease in adulthood.

The AHAs policy is to evaluate the cardiovascular status prior to conception and to monitor the cardiovascular system post-delivery, especially in the first year. Furthermore, the reports indicate that 9 out of 10 women aged 20-44 years start pregnancy in sub-optimal cardiovascular health, thus emphasizing the need for improved preventive health care.

Several changes occur during the transition to menopause which may affect cardiovascular health. Sometimes, falling and fluctuating hormone levels can lead to weight gain, high blood pressure and high Low Density Lipids (bad cholesterol).

During perimenopause and menopause, the reports should prompt women to talk with their healthcare provider about cardiovascular diseases, cholesterol level and recommended screenings. A lack of sleep is a common feature of this transition, and poor sleep has been shown to impact heart health; therefore, sleep disturbances should not be overlooked.

The publications also highlight the mutual connection between mental health and cardiovascular disease. Depression and anxiety may impact physical activity, diet and other activities related to heart health. Likewise, women with cardiovascular disease may have more psychological distress. The reports recommend incorporating mental health screening into routine cardiovascular care.

AHA also recommends eating a healthy diet, exercising regularly, and avoiding tobacco, eating a healthy weight and getting plenty of rest. It's also important to monitor blood pressure, cholesterol and blood sugar levels regularly.

The guidance invites women to talk about their menstrual, pregnancy and menopause experiences when they are consulting a healthcare professional. The publications acknowledge the reproductive health markers as significant markers of cardiovascular health, reinforcing the need for prevention and cardiovascular health checks throughout a woman's life.