Pregnancy is the ultimate heart stress test

Heart disease is not just a problem for men. It is also a leading killer of Australian women.

Julie Anne Mitchell

Heart disease is not just a problem for men. It is also a leading killer of Australian women.

It’s an unforgettable cinematic moment - Marlon Brando as Vito Corleone in The Godfather suffering a heart attack in the tomato patch while playing with his grandson.

It’s a classic Hollywood heart attack, but according to Heart Foundation Director of Prevention, Julie Anne Mitchell, it’s also an over-worked stereotype.

“Many people think that heart disease is an old man’s disease, and this is reinforced by media and movie depictions of a man clutching his chest and falling to the ground in agony,” Ms Mitchell said. “In fact, heart disease doesn’t discriminate; it affects both women and men.”

Heart disease remains a leading killer of Australian women, taking the lives of 22 females every day. Nearly three times as many women die from heart disease as from breast cancer.

It can strike women at any age and research now highlights that vascular complications in pregnancy pose an added heart disease risk for women.

Each year more than 30,000 women suffer from problems with high blood pressure when they are pregnant, such as pre-eclampsia.

“Pregnancy is the ultimate heart stress test,” said Ms Mitchell. “A woman’s blood volume increases by 30 to 50 per cent. Labour and birth trigger sudden changes in blood flow and blood pressure.

“This all forces the heart to work harder. Most women will cope with this increased demand but a small percentage will not.”

Ms Mitchell said there is still a lot we don’t know about the relationship between high blood pressure, pre-eclampsia and heart disease - for instance, does pregnancy bring to the surface an underlying condition, or does pregnancy itself change something in a woman’s cardiovascular system?

“But what we do know is that a history of pre-eclampsia quadruples the risk of a woman developing high blood pressure later in life, and doubles her risk of having a heart attack or stroke,” she said.

The World Health Organisation estimates that pre-eclampsia and related hypertension in pregnancy affects about 10 million women per year worldwide, leading to the deaths of 76,000 mothers and about half a million babies.

“In Australia, our death rates from pre-eclampsia are low, due to the excellence of our health system,” Ms Mitchell said. “However, the Heart Foundation is concerned that the care often stops on discharge for these women, when in fact their heart health should be monitored for the rest of their lives.

“It’s important that as a community we recognise heart disease is a personally relevant issue for women, and that doctors can play an important role in encouraging women to be more heart health-aware,” Ms Mitchell said.

“Women should speak with their health care provider about managing their risk if they have experienced a vascular condition in pregnancy and have their blood pressure checked regularly. The Heart Foundation also recommends a heart health check for anyone over the age of 45, or over 35 for Aboriginal and Torres Strait Islander peoples.”

For heart health information, call the Heart Foundation Helpline on 13 11 12 or visit heartfoundation.org.au.