Heart disease is the number one cause of death for women in the United States. It has also become the leading cause of death during and after pregnancy, especially for Black women. The good news is prevention and treatment can help. In fact, 80% of the time, you can lower your risk for high blood pressure, diabetes, and obesity, by simply adjusting your habits. 

High blood pressure increases the risk of babies being born too early or underweight. Although many expecting mothers with high blood pressure have healthy babies, high blood pressure during pregnancy can be risky. With this in mind, the U.S. Preventive Services Task Force (USPSTF) now recommends screening for any pregnancy-related hypertension disorders–not only preeclampsia. 

Here are four reasons pregnant women and women of childbearing age should get screened for hypertension:

 1. Hypertension during pregnancy can lead to complications.

High blood pressure before or during pregnancy can lead to serious health problems. These conditions, known as hypertensive disorders of pregnancy, or HDP, include chronic hypertension, gestational hypertension, and preeclampsia. 

Chronic hypertension refers to high blood pressure that some women may develop before pregnancy or if blood pressure is elevated before 20 weeks of pregnancy. Gestational hypertension and preeclampsia could happen after 20 weeks of pregnancy. The main difference is that preeclampsia usually includes an increased protein in the urine, and if left untreated, may cause strokes, seizures, and damage to your organs. Expectant mothers with preeclampsia are four times as likely to develop peripartum or postpartum cardiomyopathy. 

These conditions, in which the mother’s heart becomes enlarged and weakened in late pregnancy, are harmful to the baby, too. They could affect growth or result in low birth weight or stillbirth. Many complications can also lead to premature births, cesarean delivery, and preterm birth.

 2. About 45% of pregnancies are unplanned.

Given that nearly half of all pregnancies are not planned, it’s crucial for women to adopt healthy behaviors before having a child. Changing behaviors takes time and support, but that shouldn’t overwhelm you. Start with a few single steps and set realistic goals. If you need help getting started, consider following Life’s Essential’s 8 checklist from the American Heart Association. 

If you’re trying to get pregnant or think you may become pregnant, discuss a blood pressure prevention plan with your primary care provider or OB-GYN. At your next visit, ask how to control your blood pressure best and track it at home. It’s also wise to stay on top of your cholesterol, get enough sleep, maintain a healthy weight, and check your blood sugar level regularly.

 3. Certain women face higher risks.

Women with gestational diabetes, chronic hypertension, or a history of preeclampsia have a higher risk of pregnancy complications. You may also be at risk if you're carrying more than one baby, have a high body mass index, or BMI, before pregnancy, or have a family history in your first-degree relatives (mother, sister) of hypertensive disorders of pregnancy. Additionally, you may have an elevated risk if you're older than 35 or identify as a Black, American Indian, or Alaska Native woman, largely driven by the social, economic, and political determinants of health due to discrimination and chronic stressors. There’s no reason to worry, but you should know your family's health history and talk to your clinician about it.

 4. Women who have had preeclampsia have double the chance of dying from heart disease.

Women who experience hypertensive disorders of pregnancy are twice as likely to die from cardiovascular disease and four times more likely to develop hypertension later in life. These facts highlight the importance of seeing pregnancy as a window to future heart health. Research shows the importance of lifestyle changes before, during, and after pregnancy. It is also important for women to follow up with their primary care provider or OB-GYN postpartum to ensure they’re tested regularly for hypertension beyond the initial postpartum follow-up visit, typically 4 to 6 weeks after delivery.

The takeaway

You can reduce your risk for pregnancy complications by knowing your and your family’s health history, changing your habits before you may become pregnant, and tracking your blood pressure, cholesterol, and blood sugar levels. Knowing the warning signs and being proactive about your health will prepare you for an optimal pregnancy. 

Before you get pregnant, adopt a healthy lifestyle with better nutrition and a greater focus on your mental health. Stay away from tobacco products and minimize or avoid alcohol. Once you’re pregnant, start prenatal care early and talk to your St. Joseph Health primary care provider about health conditions you have now or had in the past.

Sources:

USPSTF Backs Screening for Hypertensive Disorders of Pregnancy (medscape.com)

Cardiac Disease after Pregnancy: A Growing Problem - PMC (nih.gov)

Life's Essential 8 | American Heart Association

Hypertensive Disorders of Pregnancy - PMC (nih.gov)

Hypertensive Disorders in Pregnancy and Mortality at Delivery Hospitalization — United States, 2017–2019 | MMWR (cdc.gov)

Changing Your Habits for Better Health | NIDDK (nih.gov)

Pregnancy Complications | Maternal and Infant Health | CDC

Pregnancy as a window to future health: short-term costs and consequences - American Journal of Obstetrics & Gynecology (ajog.org)

Impact of a History of Hypertension in Pregnancy on Later Diagnosis of Atrial Fibrillation | Journal of the American Heart Association (ahajournals.org)