Discordance Between Perceived Risk and Cardiovascular Health in Women of Reproductive Age
Ketum Ateh Stanislas1, Faith E Metlock1, Asma Rayani2
1Johns Hopkins School of Nursing, Baltimore, Maryland, USA; Inova Heart and Vascular Institute, Fairfax, Virginia, USA.
JACC. Advances
|June 19, 2026
Summary
Many reproductive-aged women underestimate their cardiovascular disease (CVD) and stroke risk, particularly racial/ethnic minorities. Culturally sensitive communication is crucial for accurate risk perception.
Area of Science:
- Public Health
- Cardiovascular Health
- Health Disparities
Background:
- Cardiovascular disease (CVD) is the leading cause of death for women.
- Awareness of CVD risk has declined among women of reproductive age.
- Underestimation of risk may hinder prevention efforts in this demographic.
Purpose of the Study:
- To assess the agreement between perceived cardiovascular disease (CVD) and stroke risk and objectively defined cardiovascular health.
- To identify factors predicting discordance between perceived risk and actual cardiovascular health in women of reproductive age.
Main Methods:
- A cross-sectional study involved 139 women aged 18-50 in the Baltimore/Washington DC area.
- Participants self-reported perceived CVD and stroke risk using Likert scales.
- Discordance was determined by comparing perceived risk with LE8-defined cardiovascular health status; multivariable logistic regression analyzed predictors of underestimation.
Main Results:
- Over half of the women underestimated their CVD (56.8%) and stroke (58.3%) risk.
- Racial/ethnic minority status, medium polysocial risk, low cardiovascular health literacy, and older reproductive age were associated with underestimation.
- Specifically, minority status (OR: 3.70 for CVD, 3.29 for stroke) and low health literacy (OR: 5.91 for CVD) significantly predicted underestimation.
Conclusions:
- Underestimation of CVD and stroke risk is common among women of reproductive age, with significant racial and social disparities.
- There is a critical need for targeted, culturally sensitive communication strategies to enhance accurate risk perception.
- Improving risk perception is vital for effective cardiovascular disease prevention in women.
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