Clinical Scorecard: Four societies introduce a framework for women’s cardiovascular care

At a Glance

Key Highlights

• The framework identifies four stages: perimenarche (approximately ages 8–15), ovarian cycling (15–44), perimenopause (45–51), and postmenopause (51 years and older).
• Menstrual cycle patterns are identified as a female-specific vital sign; heavy or irregular bleeding may signal cardiovascular risk associated with endocrine-metabolic conditions.
• Pregnancy complications—including hypertension, preeclampsia, gestational diabetes, preterm birth, small-for-gestational-age infants, and stillbirth—are recognized as cardiovascular risk enhancers.
• The guidance emphasizes earlier risk assessment, psychosocial health, and longitudinal risk estimation using 10- and 30-year sex-specific AHA PREVENT equations.
• The societies propose a national network of centers integrating clinical care, education and training, research, and community engagement.

Guideline-Based Recommendations

Diagnosis

• The guidance describes cardiovascular risk assessment across four hormonally defined life stages.
• Consider menstrual cycle patterns, pregnancy complications, and menopausal transitions in cardiovascular risk assessment, as described in the guidance.
• The guidance emphasizes 10- and 30-year sex-specific risk estimation using the AHA PREVENT equations.

Management

• The publications describe female-specific life-stage events as opportunities for earlier cardiovascular prevention.
• The 2026 AHA/American College of Cardiology cholesterol guideline incorporates pregnancy-related factors into cardiovascular risk assessment.
• The societies propose coordinated, interdisciplinary care through Comprehensive Centers of Excellence for Women's Cardiovascular Care.

Monitoring & Follow-up

• The guidance emphasizes longitudinal cardiovascular risk assessment across life stages.
• The source reports that approximately 60% of affected US women receive hypertension follow-up within 6 months after delivery.
• The source describes perimenopausal changes in cholesterol and metabolic health as indicators of emerging risk.

Risks

Patient & Prescribing Data

Girls and women across perimenarche, ovarian cycling, perimenopause, and postmenopause, including women with pregnancy-related cardiovascular risk factors.

The source describes risk assessment and prevention guidance, not medication prescribing details. It emphasizes life-stage-informed assessment, postpartum follow-up, and longitudinal cardiovascular risk estimation.

Clinical Best Practices

• The guidance emphasizes incorporating menstrual patterns and reproductive history into cardiovascular risk assessment.
• The publications identify pregnancy complications as cardiovascular risk enhancers and pregnancy as an opportunity to identify previously unrecognized risk.
• The source reports limited postpartum hypertension follow-up after hypertensive pregnancy complications.
• The guidance emphasizes longitudinal cardiovascular risk assessment, including during perimenopause and after menopause.
• The guidance emphasizes psychosocial health in cardiovascular risk assessment.

Related Resources & Content

• American Heart Association