Although young women strive to be healthy, few perceive themselves as at risk for heart disease and they worry far more about stress and mood disorders than their heart health, according to two preliminary studies presented at the American Heart Association's Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2019, a premier global exchange of the latest advances in population-based cardiovascular science for researchers and clinicians.

"We know that health behaviors and heart disease risk factors track strongly from childhood into adulthood, and that prevention of heart disease must start with youth, so we wanted to know what adolescent and young adult women knew about the risk of heart disease and what factors influenced their understanding and their behaviors," said Holly Gooding, M.D., M.S., assistant professor of medicine and pediatrics at Harvard Medical School and Boston Children's Hospital, who was lead author of the study on health priorities and senior author of the study on heart-healthy behaviors.

In the studies, researchers surveyed 331 young women ages 15-24 who were waiting for primary care or women's healthcare appointments at either an academic practice or community health center in Boston. Based on those findings, 32 young women gave more detailed responses in eight online focus group interviews.

In the survey, only 10 percent of the young women identified heart disease as a leading cause of death in women, and most worried little (39.6 percent) or not at all (37.2 percent) about getting heart disease. In contrast, 42.9 percent of the young women worried a lot about getting depression or anxiety.

"While stress and mood disorders were their prevailing health concerns, it is important for young women to know that while their short-term risk of heart disease is very low, their lifetime risk is often quite high, and taking care of their health now is important for reducing their lifetime risk of heart disease. It is also important to note that the thing they worry about now (depression and anxiety) can create barriers to performing heart healthy behaviors," said Courtney Brown, B.A., lead author of the study on competing health priorities and research specialist at Boston Children's Hospital.

On healthy behaviors, the researchers found:

Most of the young women (84.6 percent) had performed at least one preventive behavior in the previous year, including visiting a doctor to monitor or improve their health (78.9 percent), exercising (74.6 percent), trying to reduce stress (52.6 percent), and trying to lose weight or improve various aspects of their diet.

The most common barriers to heart-healthy actions were failing to perceive the risk (39.3 percent) and stress (32.6 percent).

In focus groups, barriers to taking action to reduce heart disease risk included time constraints, lack of access to affordable gyms and healthy food, and competing health priorities (such as pregnancy, depression and weight concerns).

"We need to meet young women where they are, both physically and on social media, in school settings and in a variety of medical settings such as urgent care and reproductive health clinics, and mentally by focusing our heart-healthy messages on things that matter to them, like mood and sexual health," Gooding said.

"It's important to remember that heart health is a long-term goal," said Mary Ann Bauman, M.D., science volunteer for the American Heart Association. "We can help encourage young women to adopt healthy behaviors -- like moving more and eating smart -- to improve confidence in the short term while setting them up for a healthy future."

The studies are limited in being conducted in one city in the Northeastern United States and in relying on self-reported attitudes and behaviors.

Co-authors for the study on competing health priorities are: Courtney A. Brown, B.A.; Jingyi Liu, B.A.; Anna C. Revette, Ph.D.; Catherine Stamoulis, Ph.D.; and Sarah D. de Ferranti, M.D., M.P.H. Co-authors for study on heart healthy behaviors are Anna C. Revette, Ph.D.; Sarah D. de Ferranti, M.D., M.P.H.; Jingyi Liu, B.A.; and Catherine Stamoulis, Ph.D. Author disclosures are on the abstract.

The National Heart, Lung, and Blood Institute funded the studies.