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AHA puts spotlight on pregnancy and heart health
2022
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chair of the report’s writing committee and a professor
of cardiology and cardiovascular research at Baylor
College of Medicine in Houston. The goal is to gain valuable
years in the fight against heart disease in women
and their children – and to help women work with their
health care team to make sure they’re getting the treatment
they need.
Khan said that in young women with no apparent
signs of heart disease, pregnancy is a “unique and
natural time” to unmask hidden risk for heart disease.
“During pregnancy, your weight changes. Your blood
pressure may change. Your glucose levels may change.
And so the combined cardiometabolic stress test of
pregnancy can be really informative and guide interventions
to reduce risk for heart disease.”
Complications such as preeclampsia (a pregnancyrelated
condition defined by high blood pressure and
organ damage), gestational diabetes (diabetes that arises
during pregnancy), gestational hypertension (high
blood pressure that arises during pregnancy), and preterm
and underweight babies can be warning signs for
later heart disease, strokes and heart failure.
“You can identify these high-risk women early on,”
Virani said. “Then you have opportunities to work on
their risk factors, whether they are seen by a primary
care clinician or by their OB-GYN.”
Among the statistics highlighted in the new
chapter:
– Rates of blood pressure-related complications in
pregnancy almost doubled in the U.S. between 1993 and
2014, from 528.9 per 10,000 births in hospitals to 912.4.
– The frequency of gestational diabetes hit 6% in
2016, up 0.4% from four years earlier.
– Cardiovascular deaths are the most common
cause of maternal deaths – at 26.5%.
– Black women face a risk of dying during or soon
after pregnancy that’s 2.5 times greater than white
women and three times greater than Hispanic women.
Overall, 10% to 20% of women will have some kind
of health issue during pregnancy. And the problems
don’t end once the pregnancy does. According to studies
cited in the guide:
– High blood pressure that develops during pregnancy
was associated with a 67% higher risk of later
cardiovascular disease.
– Preeclampsia was associated with a 75% higher
risk of later death from cardiovascular disease.
– The odds of cardiovascular disease in women who
had gestational diabetes was 68% higher compared
with those who did not.
Paying attention to such issues could make a difference
in the health of huge numbers of women, Virani
said.
In practical terms, pregnancy offers a chance to
reach women while they are sure to be in contact with
a clinician, he said. For clinicians, it’s a potential teachable
moment for explaining a woman’s risk for future
problems and “why it is important for you to take care
of yourself with good lifestyle going forward.”
The information is not just for medical experts,
Khan said. “One of the reasons that we were so interested
in bringing this data to the statistical update was
to enhance awareness and help to empower women in
regards to their own health – prior to pregnancy, during
pregnancy, and immediately following pregnancy.”
Khan said the new chapter serves an important
role in raising awareness at a time when fewer women
are aware that heart disease is the No. 1 killer of
women in America. “I do think that that is a really
important part of really connecting with women and
identifying these risk factors and finding a way to
change future cardiovascular health for women and
for their children.”
— Courtesy of American Heart Association
Complications during pregnancy are widespread,
becoming more common and often overlooked as
warning signs about a woman’s heart health.
Which is why for the first time, in an effort
to guide clinicians and empower women, the authors
of a widely used reference on the facts and figures surrounding
cardiovascular diseases are including information
on adverse pregnancy outcomes.
Pregnancy has been termed a window into the future
of a woman’s cardiovascular health, said Dr. Sadiya
S. Khan, an assistant professor of medicine and preventive
medicine at Northwestern University Feinberg
School of Medicine in Chicago. “It’s nature’s stress test.
And it is such an important time period for both mom
and child.”
Khan served on the writing committee for the
American Heart Association’s statistical update published
Wednesday in its journal Circulation. The annually
revised work, compiled in conjunction with the
National Institutes of Health, summarizes the latest,
most significant data on heart disease, stroke and related
conditions.
Adding a chapter on pregnancy complications puts
that issue “front and center,” said Dr. Salim Virani,
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