Women who have been diagnosed with preeclampsia, pregnancy-induced hypertension, or diabetes during pregnancy are now considered at risk for heart attack or stroke. That’s according to newly updated guidelines from the American Heart Association (AHA).
Women are now classified in three groups: high risk for heart disease, at risk, or ideal cardiovascular health. The high-risk group changed little from previous years and includes women with established heart disease, chronic kidney disease, or diabetes, among other risk factors.
But “the at-risk group now includes those women with pregnancy complications such as preeclampsia, gestational diabetes, or pregnancy-induced hypertension. The complications are about the same as failing the stress test doctors use to diagnose heart disease.
Other inflammatory diseases such as rheumatoid arthritis (RA) and lupus also place a woman at risk for heart disease, according to the updated guidelines.
The new information about pregnancy complications and heart risk is “a big deal,” says guideline author Ileana L. Piña, MD, a professor of medicine and epidemiology and biostatistics at Case Western Reserve University in Cleveland. “Your blood pressure may return to normal after pregnancy and your blood sugar may return to normal too, but don’t ignore these symptoms,” she says.
“If you developed gestational diabetes, follow up and say, What can I do to prevent heart disease and diabetes?’” Doctor Piña elaborates. Your doctor may recommend weight loss, aggressive lifestyle changes, and possibly medication, she says. “We are unmasking a problem early so that we can prevent full-blown cardiovascular disease.”
While the new guidelines cast a wider net to catch women at risk for heart disease, they also call for aggressive steps to control known risk factors such as high blood pressure and obesity.
For example, the guidelines call for less than 1,500 milligrams of salt per day for all women. Sugar is limited to five or fewer servings per week. It’s believed that lowering sodium content can markedly lower blood pressure, particularly among African-American women whose hypertension is salt-sensitive.”
The bottom line is clear. “You do not need to develop heart disease no matter what your family history is,” Suzanne Steinbaum, MD, director of women and heart disease at Lenox Hill Hospital in New York City. “You need to live a healthy life and if you watch your risk factors, exercise and eat a healthy diet, heart disease doesn’t need to happen to you.”
“These complications are an opportunity to detect early that there is a problem,” she says. You can then follow up with your primary care doctor to evaluate your overall cardiac risk and quickly start appropriate prevention strategies.