For women, two key life stages, pregnancy and menopause, can reveal a lot about future risk for heart disease and stroke. Understanding how your body responded during pregnancy and how it changes during menopause can offer powerful insights into your heart and brain health.
So, what’s the link between these two stages? And why is it so important to talk to your doctor about your pregnancy history during and after the menopause transition?
To explain, we asked Dr. Karin Humphries, an associate professor emeritus at the University of British Columbia in the Department of Medicine, Division of Cardiology.
Heart & Stroke: How are experiences in pregnancy and menopause related to heart health?
Dr. Humphries: There are two key points in the reproductive life cycle that have the greatest impact on the risk of heart disease and stroke. The first is pregnancy, which you could think of as a kind of stress test of the cardiovascular system in the sense that it increases blood volume, blood pressure and heart rate.
The second key point in the reproductive life cycle is menopause. That’s when estrogen levels drop, and we know that estrogen is protective with respect to cardiovascular disease.
Heart & Stroke: If you had gestational hypertension (high blood pressure) when you were pregnant, what should you watch for?
Dr. Humphries: If we regard pregnancy as a stress test, complications such as gestational hypertension (high blood pressure) or preeclampsia indicate that your system is already experiencing problems regulating your blood pressure, or, in the case of gestational diabetes, regulating your blood sugar. It’s like an early warning sign that things are not working optimally.
Most of the time, these are all conditions that will resolve after the baby is delivered.
But preeclampsia and gestational hypertension put you at increased risk for developing high blood pressure later on in life, and gestational diabetes puts you at increased risk for developing full-blown diabetes. And those are major risk factors for heart disease and stroke.
Heart & Stroke: Why is it important to share your pregnancy history — including any complications — with your doctor, regardless of age?
Dr. Humphries: Although complications are usually identified during pregnancy, we need to continue to support women’s health based on their pregnancy history. The problem is that when these things — the preeclampsia, the gestational hypertension and the gestational diabetes — resolve, which they typically do, we just don’t follow up with preventative strategies to reduce future risk.
For most women as they go in and see their healthcare provider for regular checkups, that question of, “Did you experience any complications during pregnancy?” rarely arises.
If you did have these complications during pregnancy, you and your healthcare provider really have to pay attention to this and make every effort to reduce the risk that you will ultimately develop full-blown hypertension and full-blown diabetes later in life, because these are such important risk factors for heart disease and stroke.
Heart & Stroke: What else do you need to know about heart health now that you’re in menopause or postmenopause?
Dr. Humphries: Menopause affects a woman’s heart and brain health in many ways because of the hormonal change. We know that estrogen is protective. That’s why we see lower rates of heart disease and stroke in younger women. But as we go through menopause, our estrogen decreases and that, in addition to aging, then shows up in increasing risk factors for heart disease and stroke.
Specifically, what we see after menopause is an increase in LDL cholesterol (bad cholesterol), elevations in triglycerides (that’s another form of blood fats), increases in blood pressure, weight gain and changes in insulin and blood sugar, which then impact, of course, the risk of diabetes. It’s both menopause and also aging that are driving these adverse changes that increase a woman’s cardiovascular risk.
The good news? You can take control.
Women who had complications during pregnancy face a higher risk of heart disease and stroke later in life — but that risk isn’t set in stone.
Studies show that adopting healthy habits and managing blood pressure, cholesterol and blood sugar after giving birth can bring their heart and brain risk down to the same level as women who had no complications.
- Learn more about risk factors during menopause and other life stages.
