A long-term study led by Harvard University’s Pilgrim Health Care Institute found that women living in disadvantaged communities experience worsening heart health and rapid decline as they approach menopause.
Researchers followed 1,200 women in eastern Massachusetts for more than 20 years, from pregnancy to middle age. This research Circulation: Population health and outcomesmeasured heart health at five time points using a score based on eight health and lifestyle factors, including blood pressure, cholesterol, sleep, diet, and physical activity.
Main findings
Women living in the most vulnerable areas had heart health scores about 6 to 10 points lower over 20 years of follow-up compared to women living in the most disadvantaged areas. These differences were evident 3 years after enrollment and persisted into middle age. A more rapid decline was also seen before menopause, a critical period when cardiovascular risk increases.
Socioeconomic factors also shaped the results. Women with lower incomes, less education, or who identified as non-Hispanic black had lower heart health scores throughout the study.
As heart disease remains the leading cause of death in women, these findings highlight how long-term exposure to social and environmental conditions shapes cardiovascular risk over time.
Even small differences in heart health scores can be significant. Previous studies have suggested that small decreases in these scores are associated with increased risk of cardiovascular disease and death, highlighting that these differences can have long-term effects.
“Our study shows that heart health in midlife is shaped by more than just personal choices; income, education, and neighborhood context may all play a role,” said lead author Izuddin Aris, associate professor at Harvard Medical School and the Harvard Pilgrim Healthcare Institute.
Even after researchers took income and education into account, neighborhood conditions continued to influence heart health. Women who had lived in highly vulnerable areas for years had consistently lower scores and worse cardiovascular health.
“The years around menopause may be an important time to support a woman’s heart health,” Alice added. “This is especially true for women living in under-resourced areas.”
Implications for prevention
The findings highlight an opportunity to improve access to healthy foods, safe places to be active, and quality health care so women can protect their heart health over the long term.
About Project Viva
The study used data from Project Viva, a longitudinal study that followed women from pregnancy through middle age in the early 2000s. Because the researchers collected health data repeatedly over more than 20 years, the study was able to capture long-term patterns in heart health.
sauce:
Harvard Pilgrim Healthcare Institute
Reference magazines:
DOI: 10.1161/CIRCOUTCOMES.126.013433
