Iowa City, Iowa – Women who experience preeclampsia during pregnancy face a significantly elevated long-term risk of cardiovascular disease, according to research at the University of Iowa. Associate Professor Anna Stanhewicz is leading a study focused on identifying early indicators of this risk and developing preventative strategies.
Preeclampsia, characterized by high blood pressure during pregnancy, affects approximately one in twelve pregnancies, according to Kara Boeldt, founder of the advocacy group End Preeclampsia. Boeldt, a Quad Cities native, experienced severe preeclampsia during her pregnancy and now faces cardiovascular health risks comparable to those of a smoker consuming three packs of cigarettes daily. “One in three women die of cardiovascular disease. Two of three women die of cardiovascular disease if they’ve had a hypertensive pregnancy,” Boeldt stated, highlighting the severity of the issue and the lack of widespread awareness.
Stanhewicz’s research indicates that even after pregnancy-related complications resolve, negative impacts on blood vessel function persist. Her team has observed an approximately 20% decrease in blood vessel function in women with a history of preeclampsia, a reduction comparable to that seen in individuals over the age of 65. “It’s a measurable decrease. It’s a meaningful decrease,” Stanhewicz explained. “The research that I do is really trying to understand what’s different in that window of time when these patients appear clinically normal, before they have disease.”
While widespread clinical practice changes are still years away, Stanhewicz’s lab is exploring potential interventions, including the use of existing oral medications – specifically blood pressure medications not typically prescribed to this patient group – to improve blood vessel function. “We’ve been able to show, actually, we can use that type of intervention to improve blood vessel function,” she said.
In the interim, Stanhewicz recommends that women with a history of pregnancy complications proactively establish baseline cardiovascular health assessments with their healthcare providers following childbirth. She emphasizes the importance of discussing pregnancy history and lifestyle factors to identify and manage potential risk factors. Maintaining a healthy lifestyle through diet, exercise and stress management is also crucial.
Boeldt’s organization is advocating for more comprehensive communication between medical professionals and pregnant women. She stresses the need for detailed explanations regarding blood pressure and urine tests, clarifying what results are considered normal and what warrants concern. She also highlighted the challenges in recognizing preeclampsia symptoms, which can often be mistaken for normal pregnancy discomforts like swelling, headaches, and weight gain. Boeldt recounted an experience where her husband initially dismissed her concerns about facial swelling, only for a midwife to immediately recognize it as a potential symptom of preeclampsia the following day. “If you don’t give me specifics, I may not really notice it,” she said.
Boeldt further emphasized the importance of educating not only patients but also their support networks to ensure they can effectively advocate for their loved ones. Stanhewicz echoed the need for preventative measures, noting that while effective treatments exist for cardiovascular disease once it develops, understanding and addressing the underlying changes at the blood vessel level is key to preventing its progression. “There are usually good clinical guidelines for treating the disease once it’s developed. It’s much harder to understand or prescribe something to prevent disease,” Stanhewicz said. “So that’s really the focus of my research program, is trying to understand what’s changed at the level of the blood vessel… So we can then make recommendations that will help them prevent the progression of disease.”