Women’s Heart Clinics Effective for Managing CVD Risk After Previous Pregnancy Conditions

Women with a high risk for cardiovascular disease due to previous pregnancy-related conditions have significant improvement in cardiovascular risk factors after attending a women’s heart clinic (WHC), according to a study in the Journal of the American Heart Association.

The prospective study evaluated the efficacy of a multidisciplinary women’s heart clinic for controlling cardiovascular risk factors in women with hypertensive disorders of pregnancy (HDP; gestational hypertension and preeclampsia), gestational diabetes (GD), or small-for-gestational age (SGA) infants.

The women were aged 30 to 55 years; had given birth between January 1, 2013, and December 31, 2020; and were assessed at baseline and at 6 months after attending a WHC at 1 of 3 cardiovascular sites in Melbourne, Australia.

The participants were evaluated and managed in person or via telehealth by a cardiologist, cardiovascular nurse, and dietitian. The co-primary endpoints were the proportion of women who had blood pressure (BP) of less than 140/90 mm Hg (<130/80 mm Hg if known diabetes) and total cholesterol to high-density lipoprotein cholesterol ratio (TC:HDL-C) of less than 4.5.

A total of 156 women were enrolled from May 2021 to April 2022, and follow-up was completed in October 2022. Their mean age was 41.0±4.2 years, 68.6% were White, 23.1% had HDP only, 60.3% had GD only, 13.5% had HDP and GD, and 3.2% had an SGA infant. They had an average of 3.9 years from their last delivery.

The BP target was met by 69.2% of women at baseline and 80.5% at 6 months (P =.004). The TC:HDL-C ratio target was met by 80.6% of women at baseline and 83.7% at 6 months (P =.182).

Significant improvement was observed in secondary outcomes, including decreases in mean systolic BP (-6.9 mm Hg; 95% CI, -9.1 to -4.7; P <.001), diastolic BP (-3.1 mm Hg; 95% CI, -4.4 to -1.8; P <.001), total cholesterol (-4.6 mg/dL; 95% CI, -9.1 to -0.2; P =.042), low-density lipoprotein cholesterol (-4.2 mg/dL; 95% CI, -8.2 to -0.2; P =.042), body mass index (-0.6 kg/m²; 95% CI, -0.8 to -0.3; P <.001), and waist circumference (-2.3 cm; 95% CI, -3.3 to -1.3; P <.001).

Significant increases were observed at 6 months in consumption of healthy fats and nuts, as well as a reduction in fast food intake. Physical activity increased significantly from 84.0% to 92.9% (P =.025).

Of the 131 patients who completed the surveys, 87.8% (95% CI, 82.2%-93.4%) responded that they were motivated to change their lifestyle after attending the WHC, and 91.6% (95% CI, 86.9%-96.4%) believed that the WHC was beneficial for their heart disease risk in addition to their usual general practice visits.

Among several limitations, the study was nonrandomized with no control comparator, and follow-up was 6 months owing to the COVID-19 pandemic. Also, a large proportion of women were assessed via telehealth, a high proportion had university degrees, most identified as White, and recruitment was from a hospital-based obstetric list.

“Our findings strongly support the benefit of female-specific cardiovascular health care services in risk factor control and healthy lifestyle adherence in women with past pregnancy-related conditions,” wrote the researchers.

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.