Heart disease is the leading cause of death among women in the United States who are pregnant or have given birth. Heart disease can lead to heart failure, heart attack, stroke, and sudden cardiac arrest. A recent study from the NYU School of Medicine shows that heart attack rates are on the rise in pregnant women.
A heart attack, also called myocardial infraction, occurs when the blood flow to your heart, that provides much needed oxygen, is reduced or cut off. This can happen when an artery that supplies the heart muscles with blood becomes narrowed from a buildup of fat, cholesterol and other substances forming a plaque. If this plaque breaks a blood clot will form in the artery around the plaque, leading to blockage of the artery. When the heart muscle is starved of oxygen and nutrients a heart attack can occur. Heart attacks can lead to irreversible heart damage leaving it weakened.
Overall, the risk for heart disease in women has continued to increase in the United States. Increase in risk factors such as high blood pressure, high cholesterol and diabetes in younger women are all contributing factors. When pregnant, you put more strain on your heart. You gain weight and increase blood volume as well as heart rate and blood pressure leading to the increased likelihood of a heart attack compared to a non-pregnant woman. The research team from NYU sought to study the rate of heart attack among pregnant women over time.
The study examined 49,829,753 births in hospitals across the United States where a majority of deliveries occurred, data was obtained from the U.S. Agency for Healthcare Research and Quality’s National Inpatient Survey. Of these deliveries 1,061 reported heart attacks happening during labor and deliver, and another 922 occur before birth and 2,390 during the recovery period after birth. The study also found that women between the ages of 35-39 who became pregnant were five times more likely to suffer a heart attack than those in their 20s, while women in their early 40s were 10 times more at risk. There are a few possible explanations to the increase in heart attacks from 2002 to 2014. More women are having children later in life, with the increased risk of heart attack with age and pregnancy it is possible this has influenced the rate. The increase in women with obesity and/or diabetes, which are key factors for heart attack as well, may contribute to this increase. Another factor may be that heart attacks are now easier to detect, tests that utilize early proteins markers of heart cell damage are now widely available.
Overall, the rate of heart attack was found to have increased from 7.1 of every 100,000 pregnancies in 2002 to 9.5 for every 100,000 pregnancies in 2014. Heart attack and heart attack deaths in pregnant women generally remain low, but the relatively high death rate remains despite the advancements in treating heart attacks. "Our analysis, the largest review in a decade, serves as an important reminder of how stressful pregnancy can be on the female body and heart, causing a lot of physiological changes, and potentially unmasking risk factors that can lead to heart attack," study senior investigator Dr. Sripal Bangalore, an interventional cardiologist at NYU.
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