Expert warns that high blood pressure during pregnancy could be a sign of future heart disease

Nov 5 2008

A Canadian expert is warning that high blood pressure during pregnancy could be an early warning that the woman is at risk of developing heart disease later on.

Queen's University Professor of Obstetrics and Gynecology, Dr Graeme Smith who heads a multi-university research team studying pre-eclampsia, says hearts disease is one of the top killers of women and this type of high blood pressure, which is called pre-eclampsia, occurs in 5-10% of all pregnancies.

Professor Smith says because most doctors are unaware of the connection between pre-eclampsia and the risk for future cardiovascular problems, they fail to follow up with screening tests and as a result, their patients are not taking proactive steps to avoid potential heart attacks and strokes - he believes such follow ups should be on every obstetrician's and family doctor's radar screen.

In most developed countries women have now caught up with men in terms of cardiovascular death rates and Dr. Smith, whose area of expertise is high-risk obstetrics, says what is exciting is it concerns mostly young, healthy women who now have the opportunity to protect themselves from developing a life-threatening condition years later.

In a study which began five years ago, Dr. Smith and his team have followed the progress of 400 Ontario women, half of whom developed pre-eclampsia during their pregnancy - when they were screened a year after delivery, the women with pre-eclampsia showed underlying cardiovascular risk factors of elevated blood pressure and lipids (fats) at a rate that was two to three times greater than the control group.

The researchers say they do not believe that pre-eclampsia causes these symptoms, but probably pre-dated the pregnancy and were the background upon which pre-eclampsia developed.

Dr. Smith suggests that pre-eclampsia is the earliest marker of potential future cardiovascular risk but also says that awareness is not there yet and he suggests that guidelines should be established for longer-term follow-up.

He says that pregnancy is a type of stress test for people who are already in the health care system and can reflect underlying problems that may be reduced by changes in lifestyle before medication is required.

Dr. Smith is the leader of the Canadian Institutes of Health Research (CIHR) and Heart & Stroke Foundation Pre-Eclampsia New Emerging Team (PE-NET).

The findings are published on-line in the American Journal of Obstetrics and Gynecology.