As we come to the end of Heart Month, we’d like to remind women about unique heart-health risks you may face decades before the menopause years. In the U.S., cardiovascular disease is the leading cause of death during pregnancy and the postpartum period (the weeks after delivery).
An essential part of your pregnancy-related healthcare visits, both before conception and throughout your pregnancy, is a measure of your blood pressure. If your blood pressure is not normal, we often recheck it again later in your visit. James Martin, M.D., chair of the Pregnancy and Heart Disease Task Force, reminds women and their doctors:
“Pregnancy is a natural stress test. The cardiovascular system must undergo major changes to its structure to sustain tremendous increases in blood volume. That’s why it is critical to identify the risk factors beforehand, so that a woman’s care can be properly managed throughout the pregnancy…”
High blood pressure creates risk for you and your baby. This is true whether you have a history of high blood pressure (chronic hypertension) or whether your blood pressure has only been abnormal during your pregnancy (gestational hypertension). Women with hypertension may develop preeclampsia–a very serious condition. It can lead to seizures, stroke, and can seriously affect other organs in the body. When blood flow to the placenta is abnormal, the developing baby may not get enough oxygen. Preeclampsia increases the risk of preterm birth, low birth weight, and placental abruption.
Now doctors realize that women with gestational hypertension or preeclampsia during pregnancy are at greater risk of developing cardiovascular disease (CVD) and high blood pressure later in life. Pregnancy causes increased demands on the heart, and these demands can cause long lasting changes to the cardiovascular system. These increased demands can also bring to light heart issues that were undiagnosed prior to pregnancy.
This is important information. Heart disease is the #1 cause of death for American women. Over 1 in 4 women will die of heart disease or stroke. There has long been concern that serious heart disease is misdiagnosed or undiagnosed more frequently in women than men. Some studies suggest that women are more likely to have vague symptoms or no symptoms: the so-called “silent heart attack.” These symptoms can include pain or pressure in the chest but also pain in the arm, back, neck, jaw, or stomach. Some women experience shortness of breath without chest discomfort. Others may have a cold sweat, nausea, or feeling dizzy or lightheaded.
As an active participant in your own health, you can take action by notifying your physicians (primary care, cardiologists, OB/GYN) of your history of pregnancy complications, especially gestational hypertension or preeclampsia. Their awareness that you have this risk factor may be important to your future care.
Whether you have this risk factor or not, there are ways to help manage and potentially decrease your risk of heart disease. These include having regular screenings for diabetes, high cholesterol, and high blood pressure, managing stress, and making healthy lifestyle changes. The American Heart Association’s “Life’s Essential 8” are eight key ways to help maintain cardiovascular health:
- Eat better
- Be more active
- Quit tobacco
- Get healthy sleep
- Manage weight
- Control cholesterol
- Manage blood sugar
- Manage blood pressure
When we combine knowledge of risk factors with strategies to decrease cardiovascular risk, you and your doctors can work as a team to set healthy goals. Together, we can be more aware of and prevent heart problems that may arise in the future.
Find out more from about Women’s Heart Health from the following Sources:
https://www.acog.org/womens-health/faqs/heart-health-for-women
https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8
https://www.goredforwomen.org/en/about-heart-disease-in-women/facts