Doctors are urging women who experienced preeclampsia during a pregnancy to ask their doctors about screening for potential cardiovascular problems.
Preeclampsia and other hypertensive disorders of pregnancy, characterized by high blood pressure during pregnancy, significantly increase a woman’s risk of developing high blood pressure in the long term, according to Dr. Thais Coutinho, chair of the Canadian Women’s Heart Health Centre at the University of Ottawa Heart Institute.
A woman’s risk of developing chronic high blood pressure is four times higher if she’s had one of these issues, and she faces about double the risk of having a heart attack or dying of heart disease, said Coutinho.
“This is not a sentence. It does not mean that they will develop it. It just means that their odds are higher of maybe developing the disease.”
The increased risk from one of these pregnancy-related disorders is comparable to that from other well-known risk factors like diabetes and smoking, she said. About seven per cent of pregnancies have some kind of hypertensive disorder.
Evidence of the link has been around for years, according to Dr. Kara Nerenberg, an assistant professor at the University of Calgary who was speaking on the subject at a conference in Ottawa on Thursday. The problem is, most women don’t know about it.
“Our studies show that fewer than 10 per cent of women who’ve had preeclampsia are aware that they’re at risk of future hypertension, let alone cardiovascular disease,” she said.
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Punam Gill didn’t know. Although she had preeclampsia so severe that she lost her baby at 32 weeks gestation, she said she was never told that she had a higher risk of heart disease. She only found out years later when she was having dinner with Nerenberg, a childhood friend, and hearing about her research.
One of her first questions was, “Why hasn’t my doctor told me this?” said Nerenberg.
Now that she has the information, “I can equip myself,” said Gill.
“If I have any chest pain, if I have any heartburn, if I have any symptom, I am going to get help fast.”
Nerenberg said that women who have hypertensive disorders during pregnancy should be closely monitored for six weeks after they give birth, as their risk for stroke is slightly elevated during that period.
Sometime between six weeks and six months after giving birth, she said women should discuss with a doctor how preeclampsia could affect their heart health.
Women should also be regularly screened for cardiovascular risks, such as having their blood pressure and cholesterol levels checked, as well as diabetes screening, she said.
“If their doctors are not offering, women need to direct their own therapy and get all of their cardiovascular risk screening done. They may need to ask for it.”
They should also be given assistance in reducing other risk factors by adopting a healthy lifestyle, said Nerenberg. Things like getting enough physical activity, minimizing salt intake, quitting smoking and eating more fruits and vegetables can help to reduce a woman’s overall risk for cardiovascular disease.
Nerenberg says that many physicians also aren’t aware of the link between preeclampsia and heart disease and stroke. Although there are some clinical guidelines on this in the U.S., she said no clear guidelines exist in Canada – though she’s trying to change that.