- 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.
- 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.
- Evidence review and management recommendations.
- Many questions remain, including establishing a standard screening protocol.