Improving and maintaining heart health after pregnancy can reduce the risk of future CVD

Highlights of the research:

  • An analysis of the health records of almost 110,000 women in the UK found that women with poor cardiovascular health after pregnancy or who experienced adverse pregnancy outcomes, including high blood pressure, gestational diabetes and/or preterm birth, had significantly higher long-term growth. risk of developing cardiovascular diseases.
  • Among women with adverse pregnancy outcomes, those who maintained better cardiovascular health after pregnancy had a similar risk of cardiovascular disease as women with no history of pregnancy complications.

Embargoed until 1:30 p.m. CT/2:30 p.m E.TThursday, March 21, 2024

CHICAGO, March 21, 2024 – Women with a history of adverse pregnancy complications are at a significantly higher risk of developing heart disease, but can reduce their risk by maintaining optimal heart health after pregnancy, according to a preliminary research to be presented at the American Heart Association Epidemiology. and Prevention Scientific sessions on lifestyle and cardiometabolic 2024, from March 18 to 21, in Chicago. The meeting offers the latest science on population health and well-being and lifestyle implications.

“Previous studies have shown that women with a history of adverse pregnancy outcomes tend to have a higher risk of developing cardiovascular disease later in life,” said lead study author Frank Qian, MD, MPH, Boston Medical Center Cardiovascular Medicine Fellow and Clinician. instructor at Boston University Chobanian & Avedisian School of Medicine. “However, it is unknown how much of this increased risk of cardiovascular disease can potentially be modified by healthy lifestyle behaviors.”

Adverse pregnancy outcomes examined in this study included placental abruption, gestational diabetes, small for gestational age, preterm birth, and/or hypertensive disorders of pregnancy, defined as preeclampsia or gestational hypertension. Additionally, according to the Association’s 2021 Statement on Adverse Pregnancy Outcomes and Cardiovascular Disease Risk, many adverse pregnancy outcomes are associated with the future development of CVD risk factors, such as hypertension, type 2 diabetes and dyslipidemia.

In this study, researchers reviewed UK Biobank data to assess the association between Life’s Essential 8 scores and the development of cardiovascular disease in women with and without a history of adverse pregnancy outcomes. Life’s Essential 8 are key measures defined by the American Heart Association to improve and maintain optimal cardiovascular health, including a healthy diet, physical activity, smoking cessation, healthy sleep habits, and controlling weight, cholesterol, sugar in blood and blood pressure. Cardiovascular health scores range from 0 to 100, with higher scores indicating better cardiovascular health.

The analysis found significant interactions between adverse pregnancy outcomes, cardiovascular health scores, and cardiovascular events over the 13.5-year follow-up period:

  • Women who had better measures of cardiovascular health after pregnancy, or Life’s Essential 8 scores above 76, had a 57% lower risk of developing cardiovascular disease compared to women with scores below 67.
  • Women who had complications during pregnancy and a poor cardiovascular health score after pregnancy had a 148% increased risk of developing cardiovascular disease.
  • Among women with a history of pregnancy complications, those who achieved or maintained high heart health after pregnancy had a similar risk of heart disease as women with no adverse pregnancy outcomes and good cardiovascular health .
  • Women with intermediate and low Life’s Essential 8 scores (scores of 68.2 to 77.5 and below 68.1, respectively) had an elevated risk of heart disease, 25% and 81%, respectively, both whether or not they had a history of adverse pregnancy outcomes.

“We were very surprised to find that women who had a history of pregnancy complications and achieved and maintained a high level of cardiovascular health after pregnancy significantly reduced their risk of future cardiovascular disease. They basically had a of CVD equivalent to women with no history of adverse pregnancy outcomes who also had high cardiovascular health,” Qian said.

“These findings are important for clinical practice, as well as for designing interventions and public health policies. We need to identify women at high risk and focus on ensuring they have access to means to improve their lifestyle or treatment to reduce your long-term risk of cardiovascular disease.”

Background and details of the study:

  • UK Biobank is a large biomedical database and research resource with health records of around 500,000 adults, registered from 2006 to 2010, living in the UK who received health care through the National Service of Health of the United Kingdom. The researchers accessed the data in April 2023.
  • The study included 2,263 women with a prior diagnosis of adverse pregnancy outcomes and 107,260 women who had no history of complications during pregnancy. None of the participants had cardiovascular disease at the start of the study.
  • The mean age of participants at enrollment was 50.2 years among women with a history of adverse pregnancy outcomes and 56.6 years among women without a history of adverse pregnancy outcomes.
  • During a median of 13.5 years of follow-up, 197 cardiovascular disease events were documented in women with a history of adverse pregnancy outcomes.
  • 95.2% of participants identified as white; 4.8% identified as other race, which the researcher combined as a group to meet analytic thresholds. Cardiovascular outcomes were not statistically different between the two groups, Qian said.
  • The proportion of women who had an adverse pregnancy outcome who identified as nonwhite was 8.2%, compared with 4.8% of participants who had no history of an outcome adverse pregnancy.

Limitations of the study include that it is an observational analysis, meaning the findings do not confirm cause and effect, and that over 94% of the UK Biobank study population identified as to white race, which means that the findings may not be generalizable to people of other races or ethnicities.

“Our study did not include enough women of other races or ethnicities to be able to understand how cardiovascular health metrics after an adverse pregnancy outcome may influence long-term CVD risk,” he said. Qian said. “That said, we did see a trend toward a lower risk of cardiovascular disease in women who maintained better cardiovascular health after pregnancy, so these improvements in cardiovascular health should also be beneficial for women of other races and ethnicities, although more research is needed to confirm this hypothesis.”

Nieca Goldberg, MD, associate clinical professor of medicine at NYU Grossman School of Medicine, medical director of Atria NY, and volunteer expert for the American Heart Association who was not involved in the study, said, “This is a important because it indicates a role for prevention in reducing the risk of heart disease in women who have the pregnancy-related disorders of preeclampsia, preterm birth and gestational diabetes,” he said. “When Life’s Essential 8 risk scores were applied, women with the lowest scores had a higher risk of cardiovascular disease. We should encourage healthcare professionals to integrate Life’s Essential 8 into clinical practice to improve heart health in women with and without pregnancy-related disorders. Additionally, we need additional research to evaluate the benefits of Life’s Essential 8 in various populations of women.”

Co-authors, their disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies presented at American Heart Association Scientific Meetings are solely those of the study authors and do not necessarily reflect the policy or position of the Association. The Association makes no representation or warranty as to its accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, but are curated by independent review panels and considered based on their potential to add to the diversity of scientific issues and opinions addressed at the meeting. The findings are considered preliminary until they are published as a full manuscript in a peer-reviewed scientific journal.

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Additional resources:

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The American Heart Association’s EPI|Lifestyle Scientific Sessions 2024 is the world’s premier meeting dedicated to the latest advances in population-based science. The 2024 meeting is face-to-face only, Monday through Thursday, March 18 through 21 at the Hilton Chicago. The main goal of the meeting is to promote the development and application of translational and population science to prevent heart disease and stroke and promote cardiovascular health. Sessions focus on risk factors, obesity, nutrition, physical activity, genetics, metabolism, biomarkers, subclinical disease, clinical disease, healthy populations, global health, and prevention-oriented clinical trials. The Councils on Epidemiology and Prevention and on Lifestyle and Cardiometabolic Health (Lifestyle) jointly planned the EPI|Lifestyle Scientific Conferences 2024. Follow the conference on Twitter at #EPILlifestyle24.

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