Hypertensive being pregnant, which is related to the chance of coronary heart illness later in life
PITTSBURGH, February 22, 2021 – Compared to women whose blood pressure was normal during pregnancy, women with a history of hypertensive pregnancy disorders such as preeclampsia and gestational hypertension show large differences in the structure and function of the heart a decade later, according to researchers at the university of Pittsburgh School of Medicine report today in the Journal of the American College of Cardiology.
The changes, which primarily affect the left ventricle of the heart, can predispose some women to ischemic heart disease and heart failure later in life without their knowing it. The results can help doctors identify those at high risk for long-term heart complications and allow early therapeutic interventions to prevent heart disease from developing.
“Hypertension is a silent killer,” said senior author Dr. Malamo Countouris, clinical cardiology instructor in the Pitt Medical Department and co-director of the Postpartum Hypertension Clinic at UPMC Magee-Womens Hospital. “None of the women in our study had clinical symptoms of heart disease – they are young and likely to feel fine and healthy and may not see a doctor regularly – but it’s important to get them screened for high blood pressure early.”
The researchers also found that hypertensive pregnancy disorders independently increase a woman’s risk of long-term cardiac complications, while the “double strike group” – those with a history of hypertensive pregnancy disorders who also had high blood pressure at the time of assessment – are most at risk.
Fortunately, the risk can be assessed quickly and non-invasively using an echocardiogram. Countouris and her team found that eight to ten years after delivery, 79% of women in the double stroke group had left ventricular remodeling, or relative thickening of the walls of their left ventricles. This compares with 38.2% of those who did not, 36.4% in those with a history of only hypertensive pregnancy disorders, and 46.2% in women with current hypertension alone. Both a history of hypertensive pregnancy disorder and current hypertension were also associated with poorer diastolic function of the left heart, which was due to the left ventricle becoming stiffer and not filling with blood to full capacity.
“Identifying women at high risk can provide a window of opportunity for targeted interventions to prevent heart disease,” Countouris said. “Suggesting simple lifestyle or diet changes, including regular exercise and better management of other cardiovascular risk factors, can prevent adverse changes in the heart and lower the risk of heart disease later in life.”
More studies are needed to clarify the cause and effect relationship between complicated pregnancies and long-term effects on the heart, Countouris said.
Other authors of the paper are Dr. med. Flordeliza S. Villanueva, Dr. med. Kathryn L. Berlacher and Dr. med. Janet M. Catov, all of Pitt; João L. Cavalcante, MD, of Abbott Northwestern Hospital in Minneapolis; and W. Tony Parks, MD, from the University of Toronto, Canada.
This study was funded by the AHA Go Red for Women Grant from the Magee-Womens Research Institute (16SFRN28930000) and a Fellow Research Grant from the UPMC Heart and Vascular Institute. Countouris was funded by the National Institutes of Health (National Heart, Lung, and Blood Institute Training Grant HL129964 T32).
To read or share this version online, visit https://www.upmc.com/media/news/022221-countouris [when embargo lifts].
About the University of Pittsburgh School of Medicine
As one of the country’s premier academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic research in a wide range of disciplines to harness the power of new knowledge and improve the human condition. Mostly powered by the School of Medicine and its affiliates, Pitt has been a top 10 recipient of National Institutes of Health funding since 1998. In the rankings recently published by the National Science Foundation, Pitt was ranked fifth among all American universities across the state for Research and Development Support in Science and Technology.
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