Is Pregnancy a Risk Factor for Future Cardiovascular Events?

Abstract

Pregnancy with normal course is probably not a predictor of future cardiovascular disease (CVD). Pregnancy-induced changes in cardiovascular system (CVS) develop primarily to meet the increase metabolic demands of the mother and fetus. Despite the increased workload of the heart during gestation and labor, the healthy woman has no impairment of cardiac reserve.Epidemiologic studies show that the risk of coronary artery disease is much lower in premenopausal women compared with age matched men, but the risk differential disappears in postmenopausal females. A body of research suggests that hormonal differences between pre-and postmenopause contribute to the cardioprotection for premenopausal women. The reproductive hormones primarily estrogen modulates cardiovascular function through several mechanisms such as stress-induced activation of hypothalamic pituitary-axis and sympathetic adrenomedullary system. Also, lactation is associated with a lower prevalence of hypertension, diabetes, hyperlipidemia, and CVD.Hence, pregnancy is a normal physiologic state in a women's life and may not be predictive of future CVD lest it is complicated by some adverse events. Yes-It Is a PredictorSince times immemorial, there had been a gender bias as regards to risk prediction tools. Pregnancy is a special part of women's life and pregnancy-related complications can be a The present debate is an effort to study that besides the common risk factors such as gestational hypertension, gestational diabetes, and preeclampsia, preterm delivery, assisted reproductive technology-related pregnancy events, and arrhythmias also have a bearing on future cardiovascular risk of a woman. The awareness in the medical community especially obstetricians, physicians, and cardiologists may play a pivotal role in detecting these complications and appropriate follow-up.

Cardiac Health Awareness Among Women Presenting for Routine Health Checkup at Tertiary Care Center: Time Trends Over 15 Years

“…Women have high mortality as compared with men of same age for occurrence of CVD [9][10][11][12][13] along with a unique risk profile. 14,15 In the present study, mean attendance of women (28.1 ± 2.5%) over the past 15 years presenting for routine preventive cardiac health checkup was significantly lower than that of men (i.e., 71.9 ± 2.6%). Encouraging to note was the subtle increase in the percentage of women attendance over the various time zones but the numbers are still significantly less.…”

Association of Pregnancy-Related Factors and Cardiovascular Disease in the Long Term

“…4,5 This awareness in the medical community, especially obstetricians, physicians, and cardiologists, would play a crucial role in detecting these complications and monitoring them appropriately. 6,7 Pregnancy itself soothsays the CVD in later life. Pregnancy can be a screening test for CVD.…”