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(NEW YORK) -- The number of women with risk factors for cardiovascular disease could significantly increase over the next 25 years, the American Heart Association (AHA) warned on Wednesday.

Without improving prevention and early detection tools, about six in 10 women could be diagnosed with hypertension or obesity by 2050, and risk factors could appear in children and teenagers as well, according to the AHA's scientific statement.

"Cardiovascular disease is the leading cause of death, and fewer than half of women know that fact," Dr. Stacey Rosen, executive director of Katz Institute for Women's Health and volunteer president of the AHA, told ABC News. "And the percentage of awareness is even lower in African Americans and Hispanics."

Published in the journal Circulation, the AHA's projections suggest that 59.1% of women could have high blood pressure by 2050 -- up from 48.6% in 2020 -- even as diet, physical activity and smoking rates are projected to improve.

About one in four women may have diabetes in 2050, up from 14.9% in 2020, and more than 60% are estimated to have obesity, an increase from 43.9% over the same period, according to the report.

Heart health risk factors won't hit all demographic groups of women equally, the report predicted.

High blood pressure will increase the most among Hispanic women with a projected rise of 15%, the report noted.

Additionally, more than 70% of Black women could have high blood pressure and obesity may increase the most among Asian women by nearly 26%. 

Young women and girls may also see an increase in heart risk factors, partially driven by less opportunity for exercise as well as an abundance of inexpensive foods that often are not heart health.

Estimates also suggest that nearly one-third of girls between ages 2 and 19 will have obesity, an increase from 19.6% with obesity in 2020.

Dr. Jennifer Miao, a board-certified cardiologist, told ABC News that earlier hormonal changes in girls may also contribute to cardiovascular risk later in life.

"Several studies have also shown that starting menstruation at an early age can lead to increased risk of heart disease down the road," she said.

Miao said she counsels parents that it's never too early to start thinking of heart health for their children by "choosing good foods, physical activity over screen time and regular pediatrician check-ups." 

Despite the report's predictions, Rosen stressed that meaningful progress for women's heart health is still within reach. 

"As a medical community, we have amazing tools to treat disease and detect it early, but lack when it comes to primary prevention," Rosen said, adding that managing diseases like obesity requires a time intensive, multidisciplinary approach that the current U.S. health care system is not built to support. 

She also said that optimizing health doesn't require a costly gym membership or expensive organic foods.

"Every bit of movement counts, whether that means taking a walk or standing more if you work at a desk," Rosen said.

Small, sustainable changes, like cutting back on sweetened beverages, can make a meaningful difference over time, she said.

Miao added that both the medical community and local leaders can do their part. By partnering with local health clinics, expanding home visit programs and leveraging telemedicine, health systems can extend their reach and bring essential care directly to isolated and underserved populations.

Takisha Morancy, MD, is a chief emergency medicine resident, medical ethics fellow and member of the ABC News Medical Unit.

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(WASHINGTON) -- President Donald Trump's surgeon general nominee, Dr. Casey Means, indicated she supports vaccines but stopped short of recommending certain shots during her confirmation hearing before the Senate Health, Education, Labor and Pensions (HELP) committee on Wednesday.

Means, who has a medical degree but does not hold an active medical license, appeared hesitant to say that some vaccines, such as the flu vaccine, prevent serious disease.

When asked by HELP committee chair Sen. Bill Cassidy, R-La., if she would encourage mothers to vaccinate their children with the measles, mumps and rubella (MMR) vaccine amid widespread illness in the U.S., Means said, "I absolutely am supportive of the measles vaccine, and I do believe vaccines save lives and are important part of the public health strategy."

However, she stressed personal autonomy and said each patient or parent needs to have a conversation with their doctor or pediatrician before taking any medication.

Later in the hearing, Sen. Tim Kaine, D-Va., asked Means for her opinion on the efficacy of the flu vaccine.

"Do you believe that there is evidence that the flu vaccine prevents serious disease and prevents hospitalization or deaths in children?" Kaine said.

"I believe that all patients should talk to their doctor--" Means began answering.

"And so do I, and that's not what I'm asking," Kaine interjected.

"I support the CDC's guidance on the flu vaccine," Means replied, adding that she believes the shot reduced the risk of hospitalization "at the population level."

Earlier this year, the Centers for Disease Control and Prevention announced that it was changing the childhood immunization schedule, removing the universal recommendation for multiple shots, including the flu vaccine.

Means was originally scheduled to testify before the HELP committee in October, but her appearance was postponed for four months after she went into labor.

If confirmed, Means would become the nation's top doctor, leading more than 6,000 members of the U.S. Public Health Service, including physicians, nurses, scientists and engineers working at various federal health agencies.

Means' views largely mirror those of Health and Human Services Secretary Robert F. Kennedy Jr., with a focus on tackling the chronic disease epidemic, creating a healthier food supply and expressing vaccine skepticism.

This is a developing story. Check back for updates.

ABC News' Youri Benadjaoud and Arthur Jones II contributed to this report.

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(NEW YORK) -- U.S. childhood and teen obesity rates have reached record-highs while adult obesity rates may be slowing, according to two new reports published early Wednesday by the Centers for Disease Control and Prevention (CDC).

Researchers used measured heights and weights from the National Health and Nutrition Examination Survey (NHANES) -- run by the CDC's National Center for Health Statistics -- to track trends over more than six decades.

In the first report, the team found that, in the most recent survey conducted between August 2021 and August 2023, 40.3% of adults aged 20 and older were found to be obese, including 9.7% with severe obesity and another 31.7% classified as overweight. 

By comparison, for the survey conducted between 1988 and 1994, 22.9% adults aged 20 and older were found to be obese including 2.8% with severe obesity and 33.1% classified as overweight.

However, some of the newest estimates suggest the rapid rise seen in earlier decades may be slowing slightly.

In the 2017-2018 survey, 42.4% of adults were classified as obese, which is the highest figure ever recorded. The decrease between the two most recent surveys could be indicative of a downward trend. Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor, noted that it aligns with observations of electronic medical record data.

"So, we're seeing, for the first time in decades, that there's like a leveling off and even maybe a slight decrease and I think this is like challenging a major shift from the long-held expectation that obesity would just be climbing year after year," he said.

According to Brownstein, the decrease is likely due to many factors including public health policies and education about healthier lifestyles as well as medications such as GLP-1s.

GLP-1s, or glucagon-like peptide-1 receptor agonists, mimic the GLP-1 hormone that is produced in the gut after eating.

It can help produce more insulin, which reduces blood sugar and therefore helps control Type 2 diabetes. It can also interact with the brain and signal a person to feel full, which -- when coupled with diet and exercise -- can help reduce weight in those who are overweight or obese.

Many GLP-1s have become household names, including Ozempic, Wegovy, Mounjaro, Zepbound and Trulicity.

"I do think the advent of the GLP-1s are absolutely playing a role," Brownstein said. "At that point in 2023, they weren't as widespread as they are today. So, we expect that these factors could play even more significant role in more recent times."

Dr. Justin Ryder, an associate professor of surgery and pediatrics at Northwestern Feinberg School of Medicine, said he's cautiously optimistic about the slight decrease.

However, he added that it remains to be seen whether this is a blip or if the decrease is indicative of a longer-term trend.

"We've seen dips in the past and typically, when they do, in the next reporting period it goes right back up," Ryder told ABC News. "And that's because of how the sampling is done. This is a random sample of U.S. adults."

He noted that the random sampling makes it difficult to draw firm conclusions.

"Could it just be the people who were sampled, or is it real?" he said. "And I think we won't know that until we have another set or a larger set of data over either the same sampling period or a couple more years from now."

Meanwhile, a second report found that more than one in five U.S. children and teenagers have obesity, which is the highest figure ever recorded.

The survey conducted between August 2021 and August 2023 found 21.1% of U.S. children and teenagers between ages 2 and 19 have obesity, up from 5.2% during the 1971-1974 survey.

Additionally, 7% of children live with severe obesity, an increase from the 1% seen 50 years ago, according to the report.

"This is exceptionally concerning," Dr. David Ludwig, co-director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital and professor of nutrition at Harvard School of Public Health, told ABC News.

He added that in the 1970s, "children were certainly recognized [as obese] but it was the rare child, one in 20. And now we're looking at one in five children with obesity."

Ludwig said it had seemed for a short period of time that the prevalence of obesity was decreasing at least among 2-to-5-year-olds when rates declined from 12.1% in 2009-2010 to 9.4% in 2013-2014.

At the time, he viewed it as a "glimmer of hope" -- but rates increased again and now sit at 14.9% for this age group.

"We saw that dip and we all got excited thinking that we were beginning to turn the tide," Ludwig said. "In retrospect, that was more of a statistical aberration, more of mirage than a true glimmer of hope because the trend overall has continued upward."

To reverse the trends among children, Ryder said the 2-to-5-year-old group will need lifestyle modifications such as healthier eating. The 6-to-11-year-old group will need similar methods although some medications are available, he said.

For children above age 12, Ryder said medications and bariatric surgery are options.

Nearly 23% of children ages 12 to 19 were considered obese in the most recent survey. Ryder said that means they meet the guidelines for intensive treatment, whether that's lifestyle adjustments or in combination with medications or surgery.

"I think the only way that we're going to see a downward trend in that number is if we take that adolescent group of 12- to 19-year-olds and actually start to apply the clinical practice guidelines and treat those kids seriously, offering them medications," he said.

Ishani D. Premaratne, MD, is an integrated plastic & reconstructive surgery resident and member of the ABC News Medical Unit.

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