Why the study?
Optimal cardiovascular disease prevention and management in girls and women require attention to interconnected hormonal, psychosocial, and cardiovascular health domains across the life course. However, uniquely fragmented healthcare across clinical specialties and inconsistent alignment among society guidelines contribute to missed opportunities to optimize cardiovascular health.
This multisociety scientific statement establishes the 4-stage Female Life Stage construct to harmonize guidelines and provide consensus-based clinical guidance for female-specific cardiovascular disease prevention and management across the life course.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“With adverse pregnancy outcomes, I think we're much more aware and have a lot more recognition for how preeclampsia, gestational hypertension, and gestational diabetes are long-term risk markers, but [it's important to] bring that into a life course conversation so that they don't just disappear when the pregnancy ends.”
“These projections underscore the urgency of making cardiovascular health a priority at every stage of a woman's life. This new approach gives clinicians across specialties shared guidance to recognize risk earlier, personalize prevention, and act before a heart attack, stroke or heart failure event.”
“Women make up more than half the population, and their heart health must be a part of everyday care across medicine. These publications give clinicians and health systems a shared foundation for recognizing risk throughout a woman's life.”
Enables life-stage tailored CVD prevention in women; extends hormonal and pregnancy risk data into multisociety consensus guidance.
There is growing recognition that the optimal prevention and management of cardiovascular disease in girls and women requires attention to sex-specific considerations relevant to the interconnected domains of hormonal, psychosocial, and cardiovascular health across the life course. Dysregulation in these health domains tends to co-occur and is associated with increased risk of cardiovascular disease. However, healthcare for girls and women is uniquely fragmented across clinical specialties, including pediatrics, adolescent medicine, primary care, obstetrics, maternal-fetal medicine, gynecology, cardiology, endocrinology, hematology, and neurology. Furthermore, inconsistent alignment across society guidelines contributes to missed opportunities to optimize cardiovascular health. Therefore, the American Heart Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine convened a multisociety science advisory group and developed the Female Life Stage construct. This construct defines 4 distinct and clinically meaningful stages-perimenarche (S1), ovarian cycling (S2), perimenopause (S3), and postmenopause (S4)-to enable female-specific screening, prevention, and treatment considerations. In addition, this construct incorporates pregnancy as a unique modifying life event when cardiovascular risk may emerge or be unmasked (eg, adverse pregnancy outcomes). This scientific statement crosswalks major society guidelines, synthesizes the evidence, and provides consensus-based clinical guidance for each Female Life Stage and interconnected health domain (ie, hormonal, psychosocial, and cardiovascular health). We conclude with a call to action to improve clinical workflows, enhance clinician education, and address scientific and implementation gaps to improve cardiovascular health in girls and women.
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Khan et al. (2026) conducted a review in Cardiovascular disease. Female Life Stage construct and consensus-based clinical guidance was evaluated. The multisociety Female Life Stage construct defines 4 stages (perimenarche, ovarian cycling, perimenopause, postmenopause) to guide female-specific cardiovascular disease prevention and management.
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