Heart disease has long been framed as a problem of later life, but a new study from McGill University suggests that this assumption may leave many younger women without an important opportunity for prevention. Researchers have developed and validated a prediction model designed to identify cardiovascular risk in women of reproductive age, using information that is often collected during pregnancy and the postpartum period. The approach could help clinicians recognize warning signs years before conventional risk assessments would typically begin.
The study, published in JACC: Advances, addresses a major limitation in current cardiovascular medicine. Widely used risk calculators were largely developed in older populations and generally focus on factors such as age, blood pressure, cholesterol levels, smoking and diabetes. Although these measures are important, they do not fully capture health events and conditions that are specific to women. Pregnancy, in particular, can reveal biological and metabolic vulnerabilities that may later contribute to heart disease.
“Heart disease is the leading cause of death in women, yet existing risk tools were developed in older populations and ignore factors unique to women,” said senior author Robert Platt, Professor in McGill’s Department of Epidemiology, Biostatistics, and Occupational Health and Director of the School of Population and Global Health. The researchers say that pregnancy may function as an early-life stress test, exposing cardiovascular risk that might otherwise remain hidden for decades.
To build the model, the team analyzed health data from more than 260,000 women in the United Kingdom between the ages of 15 and 45 who had given birth. The participants were followed for nearly four years after delivery, allowing researchers to examine which medical, reproductive and social characteristics were associated with the emergence of cardiovascular disease during the early follow-up period. The model was then validated to assess how accurately it could distinguish women at comparatively higher and lower risk.
Among the strongest and most informative factors were complications that are already known to affect pregnancy outcomes but are not routinely incorporated into standard cardiovascular prediction tools. These included hypertensive disorders of pregnancy, such as gestational hypertension and pre-eclampsia, as well as gestational diabetes and preterm birth. Each of these conditions can reflect abnormalities in blood-vessel function, glucose regulation, inflammation or placental biology—processes that are also closely connected to future cardiovascular disease.
The model also incorporated a broader range of health and social variables. Polycystic ovary syndrome, depression, thyroid disorders, oral contraceptive use and social deprivation were among the factors identified as potentially useful for estimating future risk. Their inclusion reflects a more comprehensive view of cardiovascular health, in which reproductive history, mental health, endocrine function and living conditions can interact with traditional medical measurements.
The findings suggest that some women who would normally be considered too young for cardiovascular screening may already carry a meaningful level of risk. A woman who experiences high blood pressure during pregnancy, delivers prematurely or develops gestational diabetes may not have elevated cholesterol or a long history of hypertension immediately after giving birth. Yet these pregnancy-related events may signal underlying vascular or metabolic changes that deserve follow-up rather than being treated as isolated episodes that end at delivery.
“Millions of women who give birth each year are never considered candidates for cardiovascular risk assessment simply because of their age,” said co-author Kristian Filion, Professor in McGill’s Departments of Medicine and of Epidemiology, Biostatistics, and Occupational Health. If incorporated into routine postpartum care, the model could help clinicians decide which patients might benefit from repeated blood-pressure and metabolic monitoring, lifestyle counselling or referral to a cardiovascular specialist. Earlier intervention could, in principle, reduce the likelihood of a heart attack or stroke later in life.
The researchers emphasize that the tool is intended to estimate risk, not diagnose heart disease or replace clinical judgment. Its performance must also be tested in populations outside the United Kingdom before it can be used broadly. The next step is validation in Canada and the United States, where patterns of healthcare access, ethnicity, pregnancy care and social deprivation may differ. In the longer term, the team hopes to develop a practical calculator that can be integrated into electronic health records, allowing pregnancy complications and other woman-specific factors to trigger personalized cardiovascular prevention at a much younger age.
Subject of Research: People
Article Title: Development and Validation of a Prediction Model for Cardiovascular Risk in Reproductive-Aged Women
News Publication Date: 27-May-2026
Web References: https://www.jacc.org/doi/10.1016/j.jacadv.2026.102760
References: JACC: Advances. DOI: 10.1016/j.jacadv.2026.102760
Keywords: cardiovascular disease, women’s health, pregnancy complications, postpartum care, gestational diabetes, hypertensive disorders of pregnancy, preterm birth, polycystic ovary syndrome, cardiovascular risk prediction, preventive medicine, McGill University
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