I barely know how to process this information, but I’m going to share it because I have to do something.
I’ve seen these headlines, stories, and studies before: preeclampsia in pregnancy linked to heart disease. It’s one of the risk factors listed by the National Heart Blood and Lung Institute that I present when I give speeches.
I guess it seemed like one of the many heart disease risk factors, lumped in with stress or family history or high cholesterol or all the others. My heart attack could have been caused by many, any, or all of those things. If it could be any of them, it’s also easy to conclude it’s none of them. It’s easier — safer? — to say we’ll never really know why. Maybe it’s just colossally bad luck.
But this morning I read this: A new population study, authored by Tuija Männistö, MD, PhD, of the National Institute of Child Health and Human Development and published just this month, found that hypertension in pregnancy appears independently linked to a 40-300% increased risk of heart, kidney, and metabolic problems later in life.
Reviewed on MedPage Today, this study is the first I’ve read to lay it out quite like this:
Gestational hypertension . . . was significantly associated with the following:
- 44% higher risk of ischemic heart disease
- 75% elevated risk of myocardial infarction (Jen’s note: that’s a heart attack)
- 300% higher risk of death from a myocardial infarction
- 78% higher risk of heart failure
- 59% elevated risk of ischemic stroke
- 91% higher risk of kidney disease
- 52% higher risk of diabetes mellitus
Not only did I have gestational hypertension, I had HELLP syndrome, considered a severe variant of pre-eclampsia. Owen and I nearly died. I was unconscious for 36 hours after his emergency birth at 31 weeks. He weighed 1 lb. 14 oz and he spent 58 days in the NICU.
We recovered, or so we thought.
But why, after I recovered and later Owen recovered, did my OB/GYN not warn me to be about the future health impact I might face?
Why, when I was the in the ER with my (as yet undiagnosed) heart attack a month after my preemie’s 10th birthday, and I told the doctors my medical history included HELLP syndrome, did this major risk factor not ring just the tiniest bell as they struggled to discern what was wrong with me?
Why, when I told my cardiologist the same history and commented that it was hard to believe that I could have such a long string of isolated bad luck, did he not tell me these crises were related?
“Post pregnancy, these women are somewhat lost in the shuffle,” Roxana Mehran, MD, an interventional cardiologist at the Mount Sinai School of Medicine in New York City and who was not involved in the study, said in an interview. “We’re not following them as closely as we should.”
The article goes on to say:
Guidelines from the American Heart Association recommend asking women about pregnancy complications as part of history taking and put preeclampsia roughly on par with a failed stress test as a risk factor.
“The time has now come for us to really focus on heart disease in women as early as their time of gestation,” Mehran urged. “For the most part, coronary disease and cardiovascular disease develops later in women than it does in men in terms of age, but this kind of a study really tells you women need the attention much earlier in life rather than waiting until disease develops.”
The reason why — why this, why me, why now? — is one of the hardest parts about my life with heart disease. And while my scary bout with HELLP syndrome may not be the reason (or the only reason) why I had a heart attack and now have heart disease, it is certainly a more logical explanation than random and unrelated health crises. (And you’d better believe I’ll be pressing all my doctors to find out more.)
So now I’m angry. Yet, strangely, at peace. All I’ve ever wanted is to know why.