Can My Pregnancy Save Me from Cardiovascular Disease?

April 24, 2010 - PRLog -- The following article is about preeclampsia and heart disease, a topic I’ve wanted to write about several times in the past, but never did. I honestly believed it would be too difficult to explain in terms understood by those who did not have a technical or health related background.

Oh boy, was I wrong! From all the emails and comments I’ve received, I’ve concluded that not only do my readers understand the more difficult topics I have written about, but many of you are asking questions I’m having a hard time answering without science journals by my side. Allow me to give you a round of applause for your tremendous effort to be the healthiest you can be, not just for yourself, but also for your unborn child. You are to be commended.

Back to Preeclampsia
Also known as toxemia, preeclampsia presents as high blood pressure due to the narrowing of the blood vessels, high protein levels in the urine, and the swelling of arms, legs, fingers and toes. It can begin sometime after the 20th week of pregnancy.

The purpose of this week’s blog is not to discuss treatment of preeclampsia. Rather I will discuss the type of woman who is susceptible to preeclampsia and the implication that it may be an indicator for specific health problems (such as cardiovascular disease) down the road. Why is this important to know? Because preeclampsia is a major cause of maternal and newborn illness and mortality and it is estimated that 2–4% of all pregnancies result in the condition. This is not something we can ignore.

Is there a relationship between preeclampsia and cardiovascular disease?
The cause of preeclampsia is still unknown, but doctors will worry when they see inflammation in the body, clotting problems, and metabolic changes in various organ systems such as the liver, lung, and kidneys. It has been observed that there are lesions in the placenta, such as fibrin deposits, damaged placental vessels (athetosis), and clots (thrombosis) that are similar to those seen by heart specialists in their cardiovascular disease patients.

The mysterious connection begins with the fact that both preeclampsia and cardiovascular disease are associated with unfavorable levels of fats in the blood, (lipid profiles which measure the level of cholesterol and triglycerides in the blood). Researchers have also noticed that both preeclampsia and cardiovascular disease present with high insulin levels, high systolic and diastolic blood pressures, high BMI (body/mass index), elevated sugar levels, low HDL cholesterol, high triglycerides, and excessive activation of the clotting system. All these similarities have led to the belief that there must be similar mechanisms at work between the two disorders.

Are there changes before a woman becomes pregnant that would make her more prone towards developing toxemia?
It is believed that certain women have inherited genetic abnormalities which predisposes them to toxemia when they become pregnant. This “metabolic syndrome” is defined as the presence of 3 or more of the 5 risk factors which include:

•abdominal obesity
•elevated blood pressure,
•elevated triglycerides,
•elevated high density lipoprotein,
•and elevation in fasting glucose levels or insulin resistance which often is present before any pregnancy.
When some, or all, of these conditions exist, pregnancy may trigger the factors that lead to toxemia.

Most common pre-pregnancy risk factors associated with induced toxemia.

1.Polycystic ovary
2.Increased testosterone
3.Obesity and increased BMI
4.Greater waist circumference
5.Hypertension (5–10% of pregnancies)
6.Increased homocysteine levels
7.Increased Insulin resistance
8.Diabetes
9.Lipid abnormalities (high cholesterol)
10.Thrombophilias (disorders of coagulation)
11.Genetic history of preeclampsia.

Are women who develop preeclampsia at higher risk of developing heart disease later in life?
It has been written that women with preeclampsia are at higher risk for the development of cardiovascular disease, hypertension, venous thrombosis, and hemorrhagic stroke later on in life. In fact, women with preeclampsia who delivered early or with infants with intrauterine growth retardation, have an eightfold higher risk of death from cardiovascular disease or ischemic heart disease as compared to women with normal pregnancies. When delivering at the end of  normal term, women had a 1.65 fold increased risk of death from cardiovascular disease if they had preeclampsia during their first pregnancy. What is this telling us? It says that there is a strong association between an infants birth weight and the mother’s mortality from heart disease.

Women with preeclampsia continue to show many of the same metabolic changes including insulin resistance (need for more insulin after you eat a sugar load) along with higher blood pressure, higher BMI (body/mass ratio) and higher lipid profiles when they are no longer pregnant. Later on in life this will predispose to atherosclerosis which will become cardiovascular disease.

Summary:
Women with preeclampsia may be at future risk for the development of heart disease. There are similar genetic and environmental risk factors for the two diseases and similar abnormalities between the two disorders. It has been suggested that women who develop toxemia should undergo screening starting at 1 year after they give birth. These women should be followed post pregnancy and offered treatment for any of the mentioned risk factors to prevent the risks of illness and death associated with heart disease. Treatment can include dietary changes, exercise, antioxidant therapy, blood pressure medications if indicated, and blood cholesterol screening and medications if needed.

If you have had preeclampsia in your pregnancy, get checked out every year following the birth of your baby. Early intervention could save your life at a time when you will certainly want to be enjoying your family.

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Since the beginning of her Obstetrics and Gynecology practice in 1982, Dr. Michele Brown has delivered more than 3,000 babies. She has her medical training to guide her in the development of Beaute de Maman's unique health and beauty products. Dr. Brown has a busy obstetrical practice in Stamford, Connecticut. As a clinical attending, she actively teaches residents from Stamford Hospital and medical students from Columbia Presbyterian Hospital in New York. Dr. Brown is a board-certified member of the American College of Obstetrics and Gynecology, a member of the American Medical Association, the Fairfield County Medical Association, Yale Obstetrical and Gynecological Society and the Women's Medical Association of Fairfield County.

Please visit http://www.beautedemaman.com.

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