Women’s Heart Health
American Heart Association puts
spotlight on pregnancy, heart health
Getty Images
Caribbean Life, February 4-10, 2022 17
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 pregnancyrelated
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 pressurerelated
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 OBGYN
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.”
— American Heart
Association