TY - JOUR
T1 - Prevention of Cardiovascular Disease in Women With Pregnancy-Related Risk Factors
T2 - A Prospective Women’s Heart Clinic Study
AU - Marschner, Simone
AU - Mukherjee, Swati
AU - Watts, Monique
AU - Min, Haeri
AU - Beale, Anna L.
AU - O’brien, Jessica
AU - Juneja, Aashima
AU - Tremmel, Jennifer A.
AU - Zaman, Sarah
N1 - Funding Information:
This project was supported by the Australian Government’s Medical Research Future Fund as part of the Rapid Applied Research Translation program through Monash Partners. S.Z. was supported by a Heart Foundation Future Leader Fellowship (ID 102627).
Funding Information:
S.Z. has received speaking honoraria from Novartis, consulting fees for an advisory committee for Medtronic, and a research grant to their institution from Abbott Vascular (Australia), none of which relate to the content of this manuscript. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2023/9
Y1 - 2023/9
N2 - BACKGROUND: Hypertensive disorders of pregnancy, gestational diabetes, and having a small-for-gestational-age baby are known to substantially increase a woman’s risk of cardiovascular disease. Despite this, evidence for models of care that mitigate cardiovascular disease risk in women with these pregnancy-related conditions is lacking. METHODS AND RESULTS: A 6-month prospective cohort study assessed the effectiveness of a multidisciplinary Women’s Heart Clinic on blood pressure and lipid control in women aged 30 to 55 years with a past pregnancy diagnosis of hypertensive disorders of pregnancy, gestational diabetes, or a small-for-gestational age baby in Melbourne, Australia. The co-primary end points were (1) blood pressure <140/90 mm Hg or <130/80 mm Hg if diabetes and (2) total cholesterol to high-density lipoprotein cholesterol ratio <4.5. The study recruited 156 women with a mean age of 41.0±4.2 years, 3.9±2.9 years from last delivery, 68.6% White, 20.5% South/East Asian, and 80.5% university-educated. The proportion meeting blood pressure target increased (69.2% to 80.5%, P=0.004), with no significant change in lipid targets (80.6% to 83.7%, P=0.182). Systolic blood pressure (−6.9 mm Hg [95% CI, −9.1 to −4.7], P<0.001), body mass index (−0.6 kg/m2 [95% CI, −0.8 to −0.3], P<0.001), low-density lipoprotein cholesterol (−4.2 mg/dL [95% CI, −8.2 to −0.2], P=0.042), and total cholesterol (−4.6 mg/dL [95% CI, −9.1 to −0.2] P=0.042) reduced. Heart-healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%, P=0.012), decreased fast food consumption (33.8% to 11.0%, P<0.001), and increased physical activity (84.0% to 92.9%, P=0.025). CONCLUSIONS: Women at high risk for cardiovascular disease due to past pregnancy-related conditions experienced significant improvements in multiple cardiovascular risk factors after attending a Women’s Heart Clinic, potentially improving long-term cardiovascular disease outcomes.
AB - BACKGROUND: Hypertensive disorders of pregnancy, gestational diabetes, and having a small-for-gestational-age baby are known to substantially increase a woman’s risk of cardiovascular disease. Despite this, evidence for models of care that mitigate cardiovascular disease risk in women with these pregnancy-related conditions is lacking. METHODS AND RESULTS: A 6-month prospective cohort study assessed the effectiveness of a multidisciplinary Women’s Heart Clinic on blood pressure and lipid control in women aged 30 to 55 years with a past pregnancy diagnosis of hypertensive disorders of pregnancy, gestational diabetes, or a small-for-gestational age baby in Melbourne, Australia. The co-primary end points were (1) blood pressure <140/90 mm Hg or <130/80 mm Hg if diabetes and (2) total cholesterol to high-density lipoprotein cholesterol ratio <4.5. The study recruited 156 women with a mean age of 41.0±4.2 years, 3.9±2.9 years from last delivery, 68.6% White, 20.5% South/East Asian, and 80.5% university-educated. The proportion meeting blood pressure target increased (69.2% to 80.5%, P=0.004), with no significant change in lipid targets (80.6% to 83.7%, P=0.182). Systolic blood pressure (−6.9 mm Hg [95% CI, −9.1 to −4.7], P<0.001), body mass index (−0.6 kg/m2 [95% CI, −0.8 to −0.3], P<0.001), low-density lipoprotein cholesterol (−4.2 mg/dL [95% CI, −8.2 to −0.2], P=0.042), and total cholesterol (−4.6 mg/dL [95% CI, −9.1 to −0.2] P=0.042) reduced. Heart-healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%, P=0.012), decreased fast food consumption (33.8% to 11.0%, P<0.001), and increased physical activity (84.0% to 92.9%, P=0.025). CONCLUSIONS: Women at high risk for cardiovascular disease due to past pregnancy-related conditions experienced significant improvements in multiple cardiovascular risk factors after attending a Women’s Heart Clinic, potentially improving long-term cardiovascular disease outcomes.
KW - cardiovascular disease
KW - pregnancy
KW - women
KW - Women's Heart Clinic
UR - http://www.scopus.com/inward/record.url?scp=85169847097&partnerID=8YFLogxK
U2 - 10.1161/JAHA.123.030015
DO - 10.1161/JAHA.123.030015
M3 - Article
C2 - 37642017
AN - SCOPUS:85169847097
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 17
M1 - e030015
ER -
