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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
PubMed

Insights

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.
Abstract

Keywords:
Life's Essential 8cardiovascular healthdiscordancerisk perceptionwomen of reproductive age

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