JACC Adv. 2026 Jun 19;5(7):102862. doi: 10.1016/j.jacadv.2026.102862. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of death among women, yet awareness has declined significantly among women of reproductive age. Risk underestimation may impede prevention efforts during this critical life stage.
OBJECTIVES: The objectives of the study were to evaluate concordance between perceived CVD and stroke risk and LE8-defined cardiovascular health status and to examine predictors of risk-cardiovascular health discordance among women of reproductive age.
METHODS: Cross-sectional study of 139 women aged 18 to 50 years in the Baltimore/Washington DC area. Participants assessed perceived CVD and stroke risk using 7-point Likert scales. Discordance was defined by cross-classifying perceived risk relative to peers with LE8-defined cardiovascular health status. Multivariable logistic regression examined predictors of underestimation.
RESULTS: Among 139 women (mean age 32.01 years), over half underestimated both CVD (56.8%) and stroke (58.3%) risk. In multivariable models, racial/ethnic minority status was significantly associated with underestimation of both CVD (OR: 3.70; 95% CI: 1.58-8.68) and stroke risk (OR: 3.29; 95% CI: 1.44-7.51), as was medium polysocial risk (CVD: OR: 2.72; 95% CI: 1.02-7.24; stroke: OR: 2.70; 95% CI: 1.04-7.02). Low cardiovascular health literacy (OR: 5.91; 95% CI: 1.05-33.31) and older reproductive age (≥32 years; OR: 2.26; 95% CI: 1.02-5.00) were additionally associated with CVD risk underestimation.
CONCLUSIONS: CVD and stroke risk underestimation is prevalent among women of reproductive age with marked racial and social disparities. Targeted, culturally sensitive risk communication strategies are needed to improve CVD and stroke risk perception accuracy.
PMID:42320107 | DOI:10.1016/j.jacadv.2026.102862