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
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Limitations

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

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit