Pregnancy and heart disease
Information and resources for health professionals.
Cardiovascular disease risk associated with pregnancy has until recent times been poorly acknowledged, researched and understood. However, we now know:
Women who have been diagnosed with either pre-eclampsia or gestational hypertension are at increased risk of subsequent hypertension and cardiovascular disease. The relative risk of chronic hypertension is four times and ischaemic heart disease twice that of women who did not experience these conditions in pregnancy.
Hypertensive disorders of pregnancy affect five to ten percent of pregnancies worldwide. In Australia, 30,000 women each year will develop high blood pressure in pregnancy and 10,000 of these will lead to preeclampsia.
About 1 in 7 pregnant women will develop gestational diabetes, also associated with increased risk of Type 2 Diabetes and cardiovascular disease later in life. AIHW data collected in 2016-2017 suggests that as many as 15 percent of Australian women may experience gestational diabetes.
There is currently limited information available for women to understand these vascular conditions, their implications for long-term cardiovascular health and actions they can take to reduce their risk.
Resources for health professionals
Clinical management advice
Guidelines and recommendations have been developed for pregnancy care and long-term management of cardiovascular risk in the United States, Europe and Australia.
The following is based on current best practice.
Hypertension in pregnancy and preeclampsia
Clinical follow-up:
- An annual blood pressure check
- Regular (five-yearly or more frequently if indicated) assessment of other CV risk factors including serum lipids and blood glucose.
Advice for women who have experienced hypertensive disorders of pregnancy:
Maintain a healthy weight
Eat a healthy diet
Engage in regular physical activity
Don’t smoke
Plan subsequent pregnancies with your obstetrician
Gestational diabetes
Clinical follow-up:
Oral Glucose Tolerance Test six weeks after the birth, then every two to three years (annually if planning subsequent pregnancies).
Advice for women who have experienced gestational diabetes:
Maintain weight within a normal range by following a healthy diet.
Take regular exercise – aim for 30 minutes of brisk walking five times a week.
Guidelines and tools
Information for patients
References
- Lowe et al. Society of Obstetrics Medicine of Australia and New Zealand 2014: Guideline for the management of hypertensive disorders of pregnanct 2014. 2014. https://www.somanz.org/content/uploads/2020/07/HTguidelineupdatedJune2015.pdf
- R Mathew, B Devanesan, Srijana, NS Sreedevi. Prevalence of hypertensive disorders of pregnancy, associated factors and pregnancy complications in a primigravida population. Gynecology and Obstetrics Clinical Medicine. 2023;3(2):119-123. doi:10.1016/j.gocm.2023.01.002
- Hospital) NHWSLHDWsNHW. Fact Sheet - High blood pressure (hypertension) in pregnancy 2018. https://www.wslhd.health.nsw.gov.au/ArticleDocuments/1021/Hypertension_Pre-Eclampsia%20COMBINED%20TM%2019-02-2018%20V1f%20FINAL.pdf.aspx#:~:text=Pre%2Declampsia%20(occurring%20in%20up,thankfully%2C%20most%20cases%20are%20mild.&text=Over%2030%2C000%20Australian%20women%20have,best%20thing%20you%20can%20do.
- Australian Institute of Health and Welfare. Incidence of gestational diabetes in Australia. 2019. https://www.aihw.gov.au/reports/diabetes/incidence-of-gestational-diabetes-in-australia/contents/about
- The Royal Australian College of General Practitioners. Management of type 2 diabetes: A handbook for general practice. Gestational diabetes mellitus. 2020.
- Nankervis A, McIntyre HD, Moses R, et al. ADIPS Consensus Guidelines for the testing and diagnosis of hyperglycaemia in pregnancy in Australia and New Zealand (modified November 2014). 2014. https://www.adips.org/downloads/2014ADIPSGDMGuidelinesV18.11.2014.pdf
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Last updated19 January 2024