THE 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 fi rst time, in an effort to guide clinicians
and empower women, the authors
of a widely used reference on the
facts and fi gures 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 signifi cant data
on heart disease, stroke and related
conditions.
Adding a chapter on pregnancy
complications puts that issue “front
and center,” said Dr. Salim Virani,
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
fi ght 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 pregnancy-related condition
defi ned 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.”
Many women see an OB-GYN for
most of their medical care, and messages
about heart health can get lost
in the transition when that phase of
their lives ends, she and Virani said.
So women should make sure information
about pregnancy complications
is shared among their doctors.
“It doesn’t have to be the clinician
who always brings it up,” Virani said.
A woman can say, “I had high blood
pressure during pregnancy. Sure,
my blood pressure has come down –
but what should I do now so my risk
of developing high blood pressure or
cardiovascular disease in the future
goes down?”
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
fi nding a way to change future cardiovascular
health for women and for
their children.”
BRONX TIMES R 40 REPORTER, FEB. 4-10, 2022 BTR
Three heart tips for women
The U.S. Food and Drug Administration
offers the following advice
to women looking to prioritize their
heart health:
A HEART-FRIENDLY DIET
Thanks to food labels, it’s easier
than ever for women to consume
heart-healthy diets. When examining
labels, look for foods that are low
in sodium and sugar. When planning
meals, avoid foods that are high in
trans fats.
In 2015, the Food and Drug Administration
ruled that trans fats
were not recognized as safe for use in
human foods and gave manufacturers
three years to remove them from
their products. The Cleveland Clinic
advises consumers to check labels for
“partially hydrogenated oils,” which
are a hidden source of trans fats. In
addition, the Cleveland Clinic notes
that foods such as cakes, pies, cookies,
biscuits, microwavable breakfast
sandwiches, and many types of
crackers contain trans fats.
HIGH-RISK CONDITIONS
Certain conditions can increase
a woman’s risk for heart disease.
While women may not be able to turn
back the clocks and prevent these
conditions from developing, they can
take them for the serious threat they
are and do their best to manage them.
High blood pressure, diabetes,
and high cholesterol can increase
a woman’s risk for heart disease.
Take medications as directed, monitor
blood sugar levels if you have
diabetes, and routinely have your
blood pressure and cholesterol
tested to ensure any preexisting
conditions are not increasing your
risk for heart disease.
ASPIRIN INTAKE
The Food and Drug Administration
notes that many physicians
prescribe aspirin to lower patients’
risk of heart disease, clot-related
strokes, and other problems related
to cardiovascular disease. However,
there are risks associated with longterm
aspirin use, and such risks
should be discussed with a physician.
According to the Administration,
bleeding in the stomach, bleeding in
the brain, kidney failure, and certain
types of stroke are some of the
potential side effects of long-term
aspirin use. Such side effects may
never appear, but the risk that they
might makes discussing the pros
and cons of aspirin well worth it.
Women can learn more about
heart disease by visiting www.fda.
gov.
GO RED - WOMEN’S HEART HEALTH
Metro Graphics
American Heart Association puts spotlight
on pregnancy and heart health
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