Four leading medical organizations on Monday published a coordinated framework that ties the prevention and management of cardiovascular disease in girls and women to distinct hormonal life stages, from the years around the first menstrual period through menopause and beyond.

The American Heart Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine jointly released three manuscripts in the journal Circulation. The documents introduce a "Female Life Stage" framework intended to address longstanding fragmentation in care and to identify opportunities for earlier risk detection and intervention. Cardiovascular disease remains the leading cause of death among women in the United States and globally, and projections indicate the burden will rise substantially by 2050 if current trends continue.

"Heart disease and other forms of cardiovascular disease don't suddenly become relevant when we become older women," said Dr. Stacey E. Rosen, a cardiologist and former volunteer president of the American Heart Association who contributed to the papers. She described the approach as "a paradigm shift in how we look at women's cardiovascular and brain health."

The framework organizes care around four hormonally defined stages. Stage 1, perimenarche, covers the transition around the first menstrual period, roughly ages 8 to 15. Stage 2, ovarian cycling, spans the years of regular ovulatory cycles, approximately ages 15 to 44, when pregnancy most often occurs. Stage 3, perimenopause, marks the transition to variable cycle length and hormonal changes, typically ages 45 to 51. Stage 4, postmenopause, begins after the final menstrual period,........

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