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After a difficult pregnancy the last thing you want to think about is heart disease. Especially when you are young and if you believe the lies that "cardiovascular disease (CVD) is a man's illness". We are sorry to be the bearers of bad news, but heart disease is actually the number one killer of women and if you had pregnancy complications or a stillbirth, you are significantly more likely to suffer from CVD. Possibly sooner than you thought.
How serious is it?
Unfortunately, it is deadly serious. According to the British Heart Foundation
There are around 3.5 million women living with a heart or circulatory disease (including heart disease and stroke) in the UK
24,000 women die from coronary heart disease each year in the UK, most commonly due to a heart attack – that's an average of 65 women per day
In fact coronary heart disease kills twice as many women as breast cancer. However, most women still don't realise it could impact them and that the risks are far higher if they had complications during their pregnancy.
According to research done by the American Heart Association, there are a number of pregnancy complications that can lead to heart disease.
"The statement reports the magnitude of risk related to several pregnancy complications:
High blood pressure in pregnancy, called gestational hypertension, increases a woman’s risk of cardiovascular disease later in life by 67%, and increases the odds of a stroke by 83%. Gestational hypertension is defined as blood pressure during pregnancy that is at or above 140/90 mm Hg after 20 weeks of pregnancy in a woman with previously normal readings.
Preeclampsia (high blood pressure during pregnancy coupled with signs of damage to liver, kidneys or another vital organ) is a severe condition and is linked to a 75% higher risk of later cardiovascular disease.
Gestational diabetes (new onset of Type 2 diabetes during pregnancy) increases a woman’s risk of cardiovascular disease by 68% and increases the risk of Type 2 diabetes after pregnancy by 10-fold.
Having a preterm delivery (childbirth before 37 weeks) has been found to double a woman’s risk of developing cardiovascular disease and is strongly associated with later heart disease, stroke and cardiovascular disease.
Placental abruption (separation of the placenta from the uterus before childbirth) is associated with an 82% increased risk of cardiovascular disease.
Stillbirth (death of a baby prior to delivery) is associated with about double the risk of CVD.
With numbers like this, it is critical that women who have had any of these complications in their pregnancy speak with a doctor to develop a plan for preventative care. This is especially important for women from Black, Hispanic or Asian backgrounds.
"More studies examining the association of pregnancy complications and cardiovascular risk in Black, Hispanic and Asian women are needed. Women in these racial/ethnic groups experience more adverse pregnancy outcomes and have higher burdens of cardiovascular disease risk factors and cardiovascular disease compared with white women."
What should you do?
While these numbers are scary, it is important not to panic. With heart disease there is a lot you can do preventatively if you know you are at risk. Speak with your doctor about your lifestyle and if there are changes you can make to your diet or exercise routines to try to improve your heart health. With added risk it is even more important to avoid all smoking (including vaping), limit alcohol intake, and to eat a heart healthy diet. Your GP can help you with ways to reduce your risk and here are some suggestions from the NHS https://www.nhs.uk/conditions/coronary-heart-disease/prevention/
Monitoring your heart
Remember, regular monitoring and checks can also help you spot anything serious early. Smart watches haven't always been the best at measuring heart health, especially for women and people of colour. But they are trying to get better and it can be a good place to start. Just please note, they are not medical devices and are not a replacement for medical grade heart monitoring equipment. There are also some amazing new technologies out there than are helping more women monitor their heart health at home. One is an new bra attachment by female founded US company called Bloomer Tech. They are aiming to provide accurate heart monitoring using your everyday bra, including nursing bras. They are in early trial stages and are looking for people to test out their new product. https://www.bloomertech.com/
SPEAK UP AND SPEAK OUT
If you are worried about anything, even the smallest pain or change - speak with a doctor and make sure they check you out properly. While chest pain is still the main symptom, other things to look out for include:
Neck, jaw, shoulder, upper back or upper belly (abdomen) discomfort.
Shortness of breath.
Pain in one or both arms.
Nausea or vomiting.
Sweating.
Lightheadedness or dizziness.
Unusual fatigue.
Heartburn (indigestion)
If you are suffering from any of these symptoms, even if you are still in your 30's, don't ignore them. Get medical help right away. When getting help, don't let anyone dismiss you for being "too young" or a "worried/anxious mom" and be sure to raise you concerns about any links between your pregnancy complications and your health. Chances are they might not be aware of the link between your pregnancy complications and heart disease as the research is reasonably new and not well publicised. Women are also 50% more likely to be misdiagnosed or dismissed when it comes to a heart attack. Often they are fobbed off, saying they are having a panic attack, indigestion, or irritable bowel syndrome.
If you can try keeping careful symptom notes about the pain, how long it lasted, what you were doing when it started, and if this has happened more than once. Just because a symptom goes away, it doesn't mean you are all clear. It is still worth getting a check from your doctor to be sure.
You are the best at knowing your own body, and if something isn't right or if you are in pain please get help right away. And if you still feel you are not being listened to, hopefully the research we have included in this article will help!
Want more information? We've written more about heart disease and other complications such as menopause in this blog post.
https://newsroom.heart.org/news/six-pregnancy-complications-are-among-red-flags-for-heart-disease-later-in-life https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000961#d1e609