6 in 10 US Women Predicted to Have Cardiovascular Disease by 2050, With Karen Maddox, MD, MPH

The prevalence of cardiovascular risk factors and cardiovascular disease (CVD) in women is projected to increase dramatically through 2050, based on a recent statement from the American Heart Association (AHA).1

Currently, >62 million women in the US are living with some form of CVD. Additionally, some health factors, including high blood pressure, obesity, and diabetes, are increasing among young girls aged 2-19. Based on current trends and with no further intervention, these numbers are only expected to rise.2

“We really wanted to provide a 30,000-foot overview of where we’re headed in women’s cardiovascular health in the US,” Karen Maddox, MD, MPH, a professor of medicine and public health and co-director of the Center for Advancing Health Services, Policy & Economics Research at the Washington University School of Medicine, told HCPLive in an exclusive interview. “We looked at both cardiovascular risk factors and events, and took what we understand about the trends and all of those things leading up to today and tried to project forward through 2050 to understand where we’re going.”

Maddox and colleagues estimated the prevalence of suboptimal levels of each component of the AHA’s Life’s Essential 8, as well as the prevalence of 4 major cardiovascular diseases, including coronary heart disease (CHD), heart failure (HF), stroke, and atrial fibrillation (AF), all 4 of which were collectively described as CVD. The baseline prevalence of each disease was estimated via data from the 2015-2020 prepandemic National Health and Nutrition Examination Survey (NHANES).1

Additional NHANES data from 2010-2020 was utilized to estimate growth or decline in age-adjusted prevalence of risk factors and clinical CVD, applying these rates to age/sex/race and ethnicity-specific prevalence for 2020-2050. The team then combined estimated prevalence by age/sex/race and ethnicity with the 2010 Census projections of population counts for 2020-2050 to generate the number of women and girls with each condition for this time period.1

Among the Life’s Essential 8 components, Maddox and colleagues determined that hypertension will increase from 48.6% in 2020 to 59.1% in 2050. Diabetes will also increase from 14.9% to 25.3%, while obesity will rise from 43.9% to 61.2%. However, hypercholesterolemia is projected to decline from 42.1% to 22.3%. Suboptimal health behaviors were largely projected to improve over time, including suboptimal diet (49% to 47.6%), inadequate physical activity (39.8% to 28.6%), and smoking (13.8% to 7.2%). However, inadequate sleep will worsen, rising from 40.3% to 42.2%.1

Overall CVD rates were all predicted to increase as well, with CHD rising from 6.85% to 8.21%, HF increasing from 2.45% to 3.6%, stroke rising from 4.14% to 6.74%, and AF from 1.58% to 2.31%. Additionally, total CVD will rise from 10.7% to 14.4%.1

When divided by racial, ethnic, and age group, Maddox and colleagues noted that Black women had the highest baseline and projected prevalence of inadequate sleep and poor diet, while Asian women had the highest projected prevalence of inadequate physical activity. Younger women – 20-44 years – had the highest prevalence of poor diet and smoking, but the lowest of inadequate physical activity. Poor sleep was more prevalent among the oldest women, who were ≥80 years.1

Ultimately, investigators determined that nearly 1 in 3 women 22-44 years of age will have some type of cardiovascular disease by 2050, which marks a significant increase from <1 in 4 currently. Of these, 1 in 6 women in the US will have some type of cardiovascular disease, largely driven by rapidly increasing rates of high blood pressure.2

“The issue is that we don’t act on things when we find them, and we don’t necessarily get everyone the recommended guidelines,” Maddox said. “Many times, when someone young is found to have high blood pressure, we don’t take these very seriously, and we say they could lose some weight or exercise more and come back in a year or two.”

Editors’ Note: Maddox reports no relevant disclosures.

References

1. Joynt Maddox KE, Reynolds HR, Adedinsewo D, et al. Forecasting the burden of cardiovascular disease and stroke in women in the United States through 2050: A scientific statement from the American Heart Association. Circulation. Published online February 25, 2026. doi:10.1161/cir.0000000000001406

2. American Heart Association. 6 in 10 US women projected to have at least one type of cardiovascular disease by 2050. Eurekalert. February 25, 2026. Accessed March 6, 2026. https://www.eurekalert.org/news-releases/1117116