Young women at high CVD risk: the postpartum window is an opportunity

  • Srivaratharajah K & al.
  • CMAJ
  • 11 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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  • The postpartum period represents a window of opportunity for identifying young women at increased cardiovascular disease (CVD) risk.
  • Pregnancy complications are among red flags for risk, say the authors of these recommendations for risk management in this population.

Why this matters

  • With risk mitigation, CVD can be “largely” prevented yet is a leading cause of death.
  • Most risk mitigation efforts focus on women after menopause, yet risk remains a concern for some younger women, too.

Key recommendations

  • Care providers and patients both often overlook nontraditional risk factors.
  • Guidelines were ambiguous until fairly recently:
    • American Heart Association’s 2016 scientific statement addressing ischemic heart disease in women noted a worrisome increase in mortality among younger women.
  • Preeclampsia, other vascular complications of pregnancy should be included in risk assessment.
  • Use of reproductive therapies, infertility, premature ovarian dysfunction all represent relevant patient history.
  • Early identification can help reduce risk for younger women.
  • Authors recommend early screening, close follow-up for premenopausal women with traditional and nontraditional risk factors.
  • Pharmacologic and “aggressive” lifestyle management are recommended.
  • Close postpartum follow-up for a year is one suggestion.

Study design

  • Evidence review and management recommendations.


  • Many questions remain, including establishing a standard screening protocol.

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