Millions more women face heart attacks and strokes without better prevention, AHA warns

Without stepped-up prevention and earlier detection, millions more U.S. women — including growing numbers in their 30s and 40s — will develop heart disease and suffer strokes over the next 25 years, the American Heart Association said. The warning frames an urgent public-health and policy problem that will affect workplaces, maternal health systems and state budgets.

The AHA attribution placed the rise squarely on a cluster of measurable trends: rising obesity and early-onset type 2 diabetes, widening rates of uncontrolled high blood pressure, and an increase in pregnancy-related complications such as preeclampsia and gestational diabetes that translate into longer-term cardiovascular risk. Clinicians and health systems are also diagnosing heart disease later in women, the association said, in part because traditional risk tools and clinical pathways were calibrated around older men.

Those operational gaps have immediate consequences. More working-age women with chronic heart disease will mean higher emergency room use, more long-term medication and specialty-care needs, and rising disability claims for employers and insurers. Public programs that underwrite maternal and primary care — Medicaid in particular — face heavier caseloads unless preventive care is expanded. The AHA links the projected rise directly to current policy choices about screening, postpartum coverage and public-health investment.

Institutional failures contribute to the trend. Primary care and obstetric workflows often end with pregnancy, leaving women with pregnancy complications without structured follow-up for hypertension or metabolic risk. Risk calculators used in clinics routinely undercount female risk in younger adults, delaying preventive interventions such as blood-pressure control and statin therapy. Health systems with limited access to community-based prevention and behavioral-health services reach fewer women who could benefit from early lifestyle and pharmacologic measures.

The rise will not be uniform. The AHA highlighted disparate burdens among Black, Indigenous and Hispanic women and those in lower-income communities, a pattern that mirrors broader inequalities in access to care and preventive resources. Policy levers at the state level matter: choices about Medicaid expansion, the length of postpartum coverage, and funding for community health workers or maternal health initiatives will change the scale and distribution of the projected burden.

The public-health response the association endorses is straightforward and operational: close gaps in screening and follow-up, expand postpartum and primary-care access, update risk-assessment tools to reflect women's life-course risks, and invest in community prevention programs that target obesity, smoking and diabetes. Those steps have cost implications up front but are positioned as investments that reduce long-term clinical and economic burdens.

For voters and policymakers, the projection reframes cardiovascular disease as not merely a geriatric issue but a working-age crisis tied to reproductive health and social policy. Lawmakers deciding Medicaid coverage windows, state funding for maternal programs, and occupational-health mandates will directly influence whether the next quarter-century brings an avoidable surge in heart attacks and strokes among younger women.

The American Heart Association called the trajectory reversible but contingent: without immediate changes in clinical practice and state and federal policy, the number of women living with cardiovascular disease will increase substantially in the coming decades, with broad consequences for families, employers and public budgets.