Pregnancy problems that help predict heart trouble
Women with Maternal Placental Syndromes (MPS) such as pre-eclampsia or gestational hypertension are up to 1.6 times more likely to experience premature heart failure or heart rhythm problems, new research shows.
The study led by Dr. Joel Ray, a professor in the Department of Medicine and the Institute of Health Policy, Management and Evaluation, analyzed data from more than one million pregnant women who gave birth in Ontario between 1992-2009. Ray, a clinician and researcher at St. Michael's Hospital, compared women with and without MPS, and then looked at which ones were later hospitalized for heart failure or dysrhythmias – abnormal heart rhythms – starting at one year after delivery.
“Events in pregnancy can be the ‘canary in a coal mine’ for a woman’s heart health,” Ray said. “For the first time, we found a pronounced tendency for heart failure and dysrhythmias in women who had a prior MPS.”
Risk factors such as high blood pressure, obesity, diabetes and high cholesterol predispose a woman to MPS in pregnancy, and to the heart problems years after pregnancy, he said. These risk factors cause an abnormality in the blood vessel system, affecting both the placenta, and later, the heart muscle.
Ray and colleagues followed the women for an average of eight years. They excluded those with conditions that may also cause heart failure or dysrhythmia such as coronary artery disease or thyroid disease, and adjusted for factors such as obesity, longstanding high blood pressure and socioeconomic status.
The data also showed that the risk for heart failure and dysrhythmias increased with the severity of MPS. Women with more severe cases, such as pre-eclampsia early on in the pregnancy, were up to 2.3 times more likely to have heart failure or rhythm disorders starting from one year after delivery.
The findings build on previous research by Ray that found a connection between women who had MPS and the rates of coronary heart disease and stroke.
“The biggest take home message here is that around a decade earlier, we’re able to see what state the mother’s heart is in,” he said.
“Our research can identify women at a young age who are at risk for heart muscle disease, not just coronary artery disease and stroke, which gives the opportunity to provide healthy interventions,” Ray said. “Doctors can provide dietary and lifestyle medications to significantly lower their risk.”
Even monitoring for high blood pressure – the biggest risk factor for heart failure and dysrhythmias – can make a significant difference, he said.
The study appears online in Heart, a British Medical Journal.