The growth of a baby puts a strain on the cardiovascular system, which can affect your health now and in the future. Learn to stay safe.
Checking your blood pressure and having other tests for heart problems is important during pregnancy.
By Sharon Liao
At 34, Leah Bahrencu was the spitting image of heart health. “I’m a group fitness trainer and nutrition consultant,” says Ella Bahrencu, who lives in Austin, Texas. However, when she became pregnant with twins, her gynecologist measured her blood pressure at a 30-week checkup. “I normally have low blood pressure, so for me it was high,” she says. But another doctor told her not to worry about her; her reading was still within a normal range.
In the weeks that followed, Bahrencu developed indigestion, bloating and shortness of breath. “I felt horrible, but I assumed it was normal with a twin pregnancy,” he says. At her 34-week appointment, it was clear something was wrong. His blood pressure was through the roof and his liver was failing. “I had to have an emergency C-section and was hospitalized for months,” she explains.
It turns out that Bahrencu suffered from a severe form of preeclampsia, or high blood pressure during pregnancy. Fortunately, he recovered, but he still needs heart checks. Because of his history of preeclampsia, he is at least twice as likely to develop heart disease in his lifetime, according to a 2017 study published in the journal Circulation..
Bahrencu’s experience highlights the importance of cardiovascular health in pregnancy, even for the healthiest of people.
A stress test for your heart
For your heart, pregnancy is “akin to running on a treadmill for 9 months,” says Afshan Hameed, MD, professor of maternal-fetal medicine and cardiology at the University of California, Irvine. “It’s like a cardiac stress test.”
Throughout pregnancy, the body increases blood volume by 30-50%. The heart beats faster to move more blood throughout the body. “These changes support the growth of the fetus, but they place additional workload on the mother’s heart,” explains Kathleen Young, MD, cardiologist and co-director of the Cardiovascular Obstetric Clinic at the Mayo Clinic in Rochester, Minnesota.
And if pregnancy were a marathon, labor and delivery would be the final sprint. Blood pressure and heart rate can increase further during labor. And the effects of pregnancy on heart health don’t go away right after the baby is born. “The heart continues to be put under extra strain as hormones fluctuate and extra blood from the uterus returns to circulation,” Young explains.
With all the strain on the heart, pregnancy can reveal undiagnosed cardiovascular problems, such as problems with how blood vessels work or congenital heart defects (structural problems of the heart present at birth), says Gina Wei, MD, chief scientific adviser. on women’s health from the National Heart, Lung, and Blood Institute. In people who already have high blood pressure or diabetes, these conditions can also worsen, increasing the chance of having a heart event.
Even if you don’t have heart problems, nearly 20% of pregnant women develop complications that can damage the heart or blood vessels, such as preeclampsia, gestational diabetes, and preterm labor.
Understand your risks
These conditions may resolve after pregnancy, but they can also lead to blood vessel changes that nearly double the risk of developing heart disease later in life, Wei says. But only 1 in 5 women are aware that pregnancy can jeopardize heart health, according to a survey published in the Journal of the American College of Cardiology.
And the risk is not only for the future. Up to 4% of pregnant women have or develop heart disease during pregnancy, and studies show that this number is increasing. According to the American College of Obstetricians and Gynecologists, cardiovascular disease, which affects the heart or blood vessels, is the leading cause of death during pregnancy and the year after delivery, accounting for 27% of pregnancy-related deaths. .
Risk factors for developing heart problems during pregnancy are high blood pressure, obesity, and age. A research review published in 2019 in the journal Medicine shows that women 35 and older are more likely to have heart-related problems during pregnancy compared to younger women. More women are delaying childbirth until their 30s and 40s, which, in part, explains the increased prevalence of pregnancy-related heart disease, says Elizabeth Langen, MD, clinical associate professor of obstetrics and gynecology and director of the cardio-obstetrics program at the University of Michigan.
Racial inequalities also play a role. For example, non-Latino black women are 3 to 4 times more likely to die from heart disease during pregnancy than white women. “It is clear that systemic racism has an impact on health,” Langen says. It’s especially important that doctors watch for any potential red flags in people of color, she says.
But most of these deaths are preventable with the right preventative measures, early detection, and proper treatment. The point is, heart problems are easily missed, misdiagnosed or mistreated, Langen says. Fatigue, bloating, and chest pain can be normal pregnancy symptoms, but they can also indicate a heart problem. “Most healthy young people can tolerate a lot of stress on the cardiovascular system” before problems or complications arise, she says. “So they don’t look sick until they’re very sick.”
Take charge of your heart health
One of the necessary first steps, as soon as you think about getting pregnant, is to create a plan with your doctor to reduce risk factors for heart disease, such as quitting smoking and reaching a healthy weight, Wei says.
This measure can protect your heart during pregnancy and for years to come. A study published in 2021 in the Journal of the American Heart Association found that new mothers with risk factors for heart disease before pregnancy or during the first trimester were more likely to have a complication, such as preeclampsia or gestational diabetes. They were 7% to 15% more likely to develop high blood pressure 2 to 7 years after delivery.
While it’s best to take care of your heart health before pregnancy, even if you’re already pregnant you can do a lot to reduce your risk.
Get screened early. An analysis by the CDC Foundation, an independent nonprofit organization that supports the Centers for Disease Control and Prevention, found that 68% of pregnancy-related deaths caused by heart problems are preventable. Some of the leading causes of these deaths were delayed diagnosis and missed screening tests. If your OB-GYN doesn’t mention it, ask him or her to run tests to determine the status of your heart health.
If you have any heart problems, see your doctor. People who already have heart problems may need the help of a cardiologist throughout their pregnancy. You may need a change in your current treatment, such as switching to a safer medication during pregnancy or taking baby aspirin to reduce the chances of preeclampsia.
Don’t stop moving. Staying active helps control weight, blood sugar and blood pressure, Young says. A review published in 2017 by Italian scientists showed that doing about 30 to 60 minutes of aerobic exercise 2 to 7 days a week reduced the risk of high blood pressure during pregnancy by 46%.
Talk about your symptoms. Signs of heart problems include shortness of breath, chest pain, fast heartbeat, and swelling in the feet, ankles, and lower legs. “The problem is that many of these symptoms coincide with the typical symptoms of pregnancy,” says Young. “But if something seems new, unusual, or out of proportion to you, don’t ignore it. Talk to your doctor.”
Reduce the consumption of highly processed foods. Fast food, soft drinks, chips, and other ultra-processed foods are often high in calories and sodium, which contributes to high blood pressure. Brazilian scientists showed that women who ate a diet rich in these foods during pregnancy were 48% more likely to develop gestational diabetes and 28% more likely to develop preeclampsia.
Focus on fruits, vegetables, and whole grains. These foods provide fiber, which can help keep blood sugar and hunger in check. They are also sources of vitamins and minerals that support heart health, such as potassium. Research shows that a diet rich in potassium can help lower blood pressure, especially in women who consume too much sodium.
Prioritize your postpartum appointments. When you’re busy caring for a newborn, your doctor’s appointments can take a backseat. According to the American College of Obstetrics and Gynecology, up to 40% of women do not attend their postpartum checkups. But two-thirds of heart-related deaths due to pregnancy occur in the year after the baby is born. Be sure to keep follow-up appointments.
Share your pregnancy history. At future appointments, tell your doctor about any complications you’ve had during your pregnancy. Many health professionals overlook this important issue. According to a survey of primary care physicians published in the Journal of the American College of Cardiology, only 16% checked all the recommended boxes, such as asking about pregnancy complications, when assessing disease risk heart in women.
The best blood pressure monitors from CR’s tests
If your doctor has recommended that you check your blood pressure at home, check out these CR test products, listed alphabetically.
A&D Medical UA767F
Omron Platinum BP5450 (Amazon)
Rite Aid Deluxe Automatic BP3AR1-4DRITE
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