Women’s cardiovascular health in 2025: Advancements achieved, challenges ahead

Cardiovascular disease (CVD) is the leading cause of death among women globally. Recognition of sex-specific risk factors, pathophysiology, and clinical presentations has established women's cardiovascular health as a research and clinical priority. Pregnancy complications, premature menopause, and autoimmune disease, are now identified as long-term contributors to cardiovascular risk, while female-predominant syndromes such as ischemia with non-obstructive coronary arteries and heart failure with preserved ejection fraction are increasingly acknowledged. Novel therapies and updated guidelines emphasize psychosocial determinants, reproductive history, and postpartum risk assessment in prevention and management. Despite these advances, women remain underdiagnosed, undertreated, and underrepresented in clinical trials. Diagnostic delays and limited access to therapies and rehabilitation persist globally, with disparities pronounced in Saudi Arabia, where obesity, diabetes, and hypertension are highly prevalent. Closing these gaps requires sustained investment in sex-specific research, equitable access to evidence-based care, and integration of women's cardiovascular health into national strategies under Saudi Vision 2030.