Overview: Maternal Cardiovascular disease

Heart disease is the leading cause of death for men, women in the United States.

February is American Heart Month, and in celebration, the American Heart Association (AHA) and Sharp HealthCare held a virtual community conversation about maternal health. The virtual meeting included guest speakers such as Dr. Marin Nishimura, a physician in cardiovascular disease and internal medicine at Sharp Grossmont Hospital, and Dr. Lisa Johnston, a children’s specialist and chief medical officer at Sharp Mary Birch Hospital for women and newborns in San Diego.

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As part of the AHA’s Go Red for Women campaign, women are encouraged to take charge of their heart health through a passionate, emotional and social initiative. 

“In 2003, the National Heart, Lung and Blood Institute (NHLBI), the AHA and other organizations committed to women’s health joined together to raise awareness of women and heart disease,” according to the Go Red for Women website.

Women’s health, pregnancy-related cardiovascular conditions during and after pregnancy were discussed during the virtual community conversation.

In most cases, “heart disease is the leading cause of death for men, women in the United States. One person dies every 34 seconds in the U.S from cardiovascular disease,” according to the Centers for Disease Control and Prevention (CDC).

Heart disease also happens to be the leading cause of maternal death. Based on the 2020 Maternal Mortality Rates report, 861 women were identified as having died of maternal causes in the United States, compared with 754 in 2019. It also states on their page that the mortality rate for Latina women is 11.8%.

heart diseases death
Map of heart disease death rates.-CDC

AHA board member and webinar moderator Debbie Day explained how age, weight, race, ethnicity and high blood pressure are all factors that contribute to maternal health.

Day said that women aged 35 and older are at higher risk for medical complications and death during and after pregnancy. Women age 40 and older are eight times more likely to succumb to complications than women under the age of 25.

Pregnancy-related mortality rates were significantly higher among Black women with 42.8%. Mortality rates for white women are 13% and only 11.8% for Latina women, according to the report.

High blood pressure, also known as hypertension, is on the rise, Day said. She also stated that rates during pregnancy have increased substantially among women hospitalized in the U.S. since 1993.

“Obesity is also a major risk factor and could account for nearly one-third of a steep increase in the U.S. in pregnancy related deaths,” Day said.

causes of pregnancy death
Causes of pregnancy-related deaths in the U.S. – CDC

The importance of women’s heart disease was discussed by Dr. Nishimura. She explained how cardiovascular disease is the leading cause of death worldwide, which is why it is important for her to raise awareness about the disease not only for women but for men as well, as it affects both genders significantly.

“Cardiovascular disease kills more women than all forms of cancer combined, and yet only 44% of women recognize that cardiovascular disease is their greatest health threat,” according to Go Red for Women. Those diseases include chronic lung disease and diabetes combined.

Dr. Nishimura said that in 2014, one in 32 female deaths were caused by breast cancer, whereas 1 of  3 were caused by cardiovascular disease.

Although cardiovascular disease is the number one cause of death for women, it is also a largely preventable disease. “Nearly 80% can be prevented with better lifestyle choices such as not smoking, regular exercising and eating a healthy diet,” Dr. Nishimura said.

People who are at risk of cardiovascular disease include those who have a family history of coronary disease, stroke history, high blood pressure, high cholesterol, diabetes, obesity, chronic kidney disease and smoking history. Dr. Nishimura said that risk factors specific to women include: early menopause, hormone therapy, breast cancer, polycystic ovarian syndrome and autoimmune diseases.

“Several pregnancy complications, such as preeclampsia and gestational diabetes, are considered independent risk factors for future heart disease,” DR. Johnson. “Also, abnormality during pregnancy can mean an early indicator of later cardiac risk.” 

Pregnancy acts as a natural stress test for the heart by increasing blood flow and temporarily spiking blood pressure and blood glucose. “Labor and delivery also add to your heart’s workload,” Dr. Johnston said. 

Preeclampsia, also known as high blood pressure or hypertension, can occur during pregnancy and after pregnancy. “Preeclampsia diagnosis approximately doubles a woman’s risk for heart disease and stroke over the next five to 15 years,” Dr. Johnston said. 

Additionally, Dr. Johnston discussed the risk factors for preeclampsia, including obesity, kidney disease, hypertension, preeclampsia in previous pregnancies, being pregnant with more than one child, and Type 1r Type 2 diabetes before pregnancy. “Women that are just 20 pounds or more overweight, have a family history of HBP or have reached menopause are known to increase a woman’s risk,” according to the Go Red for Women website.

Complications of preeclampsia include: fetal growth restriction, preterm birth, placental abruption, eclampsia, organ damage and cardiovascular disease.

Dr.Johnson said that women suffering from severe preeclampsia may need to be hospitalized for a period of time to be properly observed. Medication may be provided to lower blood pressure or to prevent seizures.

Additionally, she advised that preeclampsia during pregnancy is best treated by delivering the baby or managing it until the best time to deliver, as well as monitoring your blood pressure and baby’s health.

Experts say that gestational diabetes is another major risk factor to be aware of, as it can develop during pregnancy. “Gestational diabetes develops around the 24th week of pregnancy,” and “the development of diabetes at any age can increase the likelihood of heart disease and high blood pressure during pregnancy,” Dr. Johnston said.

Gestational diabetes may affect the health of your baby. Babies may be at risk of having diabetes Type 2 or being born prematurely, which can cause breathing problems, Dr. Johnston said.

Lowering the risk of gestational diabetes may be accomplished by maintaining a healthy body weight after delivery, getting blood sugar tested, eating healthy and committing to exercise.

For more information about women’s heart disease or maternal health, you can visit Go Red for Women or the American Heart Association.

Also, you can find more news about the health of pregnancy women here.

Amairani Hernandez is a native of Los Angeles and a graduate of the California State University of Los Angeles with a degree in Broadcast Journalism. She is a staff multimedia journalist, who focuses on...