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Pregnancy and heart disease

Information and resources for health professionals.

Cardiovascular disease risk associated with pregnancy has until recent times been poorly acknowledged, researched and understood. However, we now know:

Women who have been diagnosed with either pre-eclampsia or gestational hypertension are at increased risk of subsequent hypertension and cardiovascular disease. The relative risk of chronic hypertension is four times and ischaemic heart disease twice that of women who did not experience these conditions in pregnancy [1].

Hypertensive disorders of pregnancy affect five to ten percent of pregnancies worldwide. In Australia, 30,000 women each year will develop high blood pressure in pregnancy and 10,000 of these will lead to preeclampsia [2] [3].

Between five and ten percent of pregnant women will develop gestational diabetes, also associated with increased risk of Type 2 Diabetes and cardiovascular disease later in life. AIHW data collected in 2015 suggests that as many as 10.5 percent of Australian women may experience gestational diabetes [4].

There is currently limited information available for women to understand these vascular conditions, their implications for long-term cardiovascular health and actions they can take to reduce their risk.

Resources for health professionals

Guidelines and recommendations have been developed for pregnancy care and long-term management of cardiovascular risk in the United States, Europe and Australia.

The following is based on current best practice.

Hypertension in pregnancy and preeclampsia

Clinical follow-up:

  1. An annual blood pressure check
  2. Regular (five-yearly or more frequently if indicated) assessment of other CV risk factors including serum lipids and blood glucose [1]. 

Advice for women who have experienced hypertensive disorders of pregnancy:

  • Maintain a healthy weight
  • Eat a healthy diet
  • Engage in regular physical activity
  • Don’t smoke
  • Plan subsequent pregnancies with your obstetrician

Gestational diabetes

Clinical follow-up:

Oral Glucose Tolerance Test six weeks after the birth, then every two to three years (annually if planning subsequent pregnancies) [2].

Advice for women who have experienced gestational diabetes:

  • Maintain weight within a normal range by following a healthy diet.
  • Take regular exercise – aim for 30 minutes of brisk walking five times a week.

[1] Lowe et al. Society of Obstetric Medicine of Australian and New Zealand 2014. Guideline for the Management of Hypertensive Disorders of Pregnancy 2014. Sydney: SOMANZ.

[2] Australian Diabetes in Pregnancy Society Consensus Guidelines for the Testing and Diagnosis of Hyperglycaemia in Pregnancy in Australia and New Zealand (modified November 2014).

 

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