Adverse pregnancy outcomes linked to midlife cardiovascular disease risk

Adverse pregnancy outcomes linked to midlife cardiovascular disease risk | Image Credit: © Wedding photography - © Wedding photography - stock.adobe.com.

There is an association between adverse pregnancy outcomes and cardiovascular disease during menopause, according to a recent study presented at the 2024 Annual Meeting of The Menopause Society.¹

Pregnancy-related hypertension has been linked to multiple adverse health outcomes later in life. These include more bothersome symptoms of menopause such as hot flashes, stroke, kidney problems, and dementia risk. However, the recent study evaluated the risks of heart outcomes among postmenopausal women with adverse pregnancy outcomes.

Pregnancy outcomes assessed included preeclampsia or eclampsia, gestational hypertension, and gestational diabetes. These outcomes were determined based on self-reports from approximately 400 women aged a mean 81.6 years.

Results indicated an increased risk of cardiovascular disease among women self-reporting a history of gestational hypertension. Additionally, a higher prevalence of heart disease was identified in those reporting a history of preeclampsia or all 3 adverse pregnancy outcomes, but this increase was not statistically significant.

No association was reported between gestational diabetes and heart disease. Marie Tan, lead author, recommended additional research using a large sample size to determine the impact of pregnancy outcomes on cardiovascular disease onset.

Additional study details were discussed at the 2024 Annual Meeting of The Menopause Society during the presentation, “The association between adverse pregnancy outcomes and cardiovascular disease in menopausal women: results from a cross-sectional analysis."

"Cardiovascular disease is the number one cause of mortality in women and it's important to study any new risk factors" said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. "Although future research is still needed, studies like this are important and remind us to thoroughly discuss a patient's health history.”

Women with menopause will often experience a natural increase in cardiovascular disease risk, as hot flashes during menopause have been linked to an increased risk.² Approximately 70% of midlife women experience hot flashes, making it vital to manage adverse health outcomes such as cardiovascular disease.

During the MsHeart study, hot flashes among menopausal women were objectively measured using sternal skin conductance. Participants experiencing hot flashes measured physiologically while awake had increased levels of a high-sensitivity C-reactive protein, indicating increased cardiovascular disease risk.

The association between hot flashes and high-sensitivity C-reactive protein levels was also reported after adjustments were made for age, race and ethnicity, education, estradiol, and body mass index. This indicated a method of identifying women in need of direct interventions for decreased cardiovascular disease risk.

Faubion noted that heart disease is the leading cause of death among women in the United States, making studies such as these vital for women’s health. Health care professionals should ask their patients about hot flash experience in order to assess other risk factors of cardiovascular disease.

As noted by Natalie Bello, MD, MPH, FACC, patients with complications of pregnancy may experience significantly increased blood pressure requiring diet and lifestyle modifications for treatment.³ In certain cases, medication may be necessary to prevent cardiovascular disease in these patients.

“I think for folks who are taking care of pregnant patients, it's really important to have a high index of suspicion for cardiovascular disease, and to think about those risk factors,” said Bello. “It's also really important for clinicians who care for patients around the time of pregnancy to realize that this may be one of the only touch points our patients have with the medical system.”

Reference

1. Some adverse pregnancy outcomes may increase risk of heart disease later in life. The Menopause Society. September 10, 2024. Accessed September 10, 2024. https://menopause.org/press-releases/some-adverse-pregnancy-outcomes-may-increase-risk-of-heart-disease-later-in-life
2. Krewson C. Hot flashes linked to cardiovascular disease. Contemporary OB/GYN. October 3, 2023. Accessed September 11, 2024. https://www.contemporaryobgyn.net/view/hot-flashes-linked-to-cardiovascular-disease
3. Krewson C. Exploring the intersection of heart health and women's health. Contemporary OB/GYN. February 12, 2024. Accessed September 11, 2024. https://www.contemporaryobgyn.net/view/exploring-the-intersection-of-heart-health-and-women-s-health