New mothers who have had pre-eclampsia, or high blood pressure, are being urged to recognise the symptoms and have regular heart checks.
Experts have made the call in the wake of mounting evidence that pregnant women with hypertensive complications have an increased risk of heart disease later in life.
Doctors once thought pre-eclampsia caused no lasting health complications after pregnancy. But research from Penn State has shown that it can increase a woman’s lifelong risk of developing cardiovascular disease.
After pregnancy, the blood vessels of women who had suffered pre-eclampsia work differently and might lose their ability to completely dilate, researchers found.
Women with pre-eclampsia are also four times more likely to suffer heart failure, according to research from Keele University.
What is pre-eclampsia?
Hypertension, or high blood pressure, is the most common medical complication in pregnancy.
“Pre-eclampsia usually takes the form of high blood pressure and abnormal kidney function, but it can also involve other organs, such as the liver, blood and brain,” said GP Dr Felicity Dent, from the Jean Hailes Foundation for Women.
In Australia, mild pre-eclampsia occurs in 5-10 per cent of pregnancies. Severe pre-eclampsia occurs in 1-2 per cent of pregnancies.
Signs of pre-eclampsia
Some women will have no symptoms. But the three most common features are high blood pressure, protein in urine and swollen legs and water retention.
Other signs can include:
- Severe headaches
- Vision problems, including burred eyesight, loss of vision or sensitivity to light
- Nausea and vomiting
- Increasing shortness of breath, caused by a build up of fluid in the lungs
- Abdominal pain
What causes pre-eclampsia?
The exact causes are unknown, although it does appear the DNA a woman inherits from her parents might increase the risk of developing pre-eclampsia.
Protein made by the growing baby might also increase the risk.
Another trigger appears to be faulty placenta development. The placenta grows from the lining of a woman’s womb to nourish the foetus during pregnancy. In a faulty placenta, blood vessels don’t develop or work properly, which can lead to reduced blood flow.
Women with pre-existing high blood pressure also have an increased risk of developing pre-eclampsia.
“During pregnancy, their blood pressure and the baby’s growth and wellbeing needs to be measured frequently,” Dr Dent said.
“A pregnant woman with pre-existing high blood pressure may also be advised to take low-dose aspirin, with or without calcium, to help reduce her risk.”
The reason that pre-eclampsia might increase heart disease risks is not yet fully understood.
“The jury is still out on whether pre-eclampsia itself puts women at higher risk later in life of high blood pressure and heart disease,” the Heart Foundation’s NSW director of health programs, Julie Anne Mitchell, said.
“Or whether pregnancy, as a natural stress test for the body, brings to the surface an underlying issue.”
How to reduce your heart disease risk
Dr Dent said lifestyle interventions could reduce the risk of heart disease by 4-13 per cent.
Such habits include maintaining a healthy weight, eating a healthy diet, exercising regularly and avoiding smoking.
“Women should also have their blood pressure checked annually and have a blood test at least every five years to check their cholesterol and glucose levels,” Dr Dent said.
The good news is that the condition is manageable with preventative steps.
“It is important for all women to know that if you have suffered from pre-eclampsia, it doesn’t mean you are destined for a heart attack,” Ms Mitchell said.
“Instead, consider it as an early warning sign to actively take steps to maintain good heart health.”