A New Reason to Watch Your Blood Pressure During Pregnancy
Gestational hypertension could be a warning sign for severe menopause and heart disease later in life. Here's what to know.
If you know someone who developed high blood pressure during pregnancy, we’re not surprised. High blood pressure occurs in one of every 12 to 17 pregnancies among women aged 20 to 44 in the U.S. The Centers for Disease Control and Prevention (CDC) report that gestational hypertension (the medical term for this) is indeed becoming more common, and unfortunately, it's putting women at risk for serious complications like preeclampsia, eclampsia, stroke, preterm delivery, and fetal abnormalities.
But that’s not all–new research in Menopause has found a link between high blood pressure disorders during pregnancy and severe menopause symptoms like hot flashes and night sweats later on. This builds upon previous research connecting gestational hypertension to an increased risk for heart disease later in life.
In other words, blood pressure problems during pregnancy can be a sign of health issues to come. “Your health during pregnancy may in fact be a preview of what’s going to happen later in your life, such as diabetes, hypertension, or heart disease,” says Owen Montgomery, M.D., OB/GYN at Jefferson University Hospitals in Philadelphia. Even after giving birth, this is something to keep a close eye on.
Risks of High Blood Pressure During Pregnancy
Gestational hypertension is defined as high blood pressure that first occurs after 20 weeks of pregnancy–as opposed to chronic hypertension, which was present before you became pregnant. If left untreated, this form of high blood pressure can cause serious problems for the mother and baby.
The most common is preeclampsia, which occurs in 1 in 25 pregnancies in the U.S. and is categorized as sudden high blood pressure and excess protein in urine. It sometimes occurs without symptoms, but preeclampsia can also cause persistent headache, vision changes, stomach pain, nausea, and other issues. In severe cases, this can lead to eclampsia, a complication that causes agitation, seizures, and loss of consciousness. If you do develop preeclampsia, doctors usually recommend delivery to prevent the condition from progressing. If it's still too early before your due date, your doctor may hospitalize you for monitoring as well as prescribe medication to lower your pressure and help speed development of your baby's lungs.
The Menopause Connection
Though gestational hypertension often resolves itself after pregnancy, it can be a warning sign for further issues later in life, including serious menopause symptoms. Stephanie Faubion, M.D., lead author of this Menopause study and director of the Mayo Clinic Center for Women’s Health in Rochester, MN, explains that what prompted this research was previous data linking both hypertension and severe menopause symptoms to heart disease.
Earlier research in Menopause found a connection between frequent hot flashes and poor blood vessel function, especially among women between ages 40 and 53 years old. Multiple studies have observed a link between gestational hypertension and cardiovascular disease, including a study in the Annals of Internal Medicine that found that women with gestational hypertension had increased risk of chronic hypertension, type 2 diabetes, and high cholesterol after pregnancy. So, the question was…are menopause and gestational hypertension independently connected as well?
“We wanted to see if those two seemed to be linked together specifically,” Dr. Faubion says. And sure enough, they found that women who reported having high blood pressure disorders during pregnancy were also likely to report menopausal symptoms like hot flashes and night sweats, even if their blood pressure had normalized again after pregnancy.
The reason for this isn’t totally clear, but Dr. Faubion guesses it’s all connected back to cardiovascular disease risk. “Each of these are markers of people who are at higher risk, and they’re helping us identify who we should really be looking at to reduce cardiovascular risk,” she says. Doctors are learning more about how to identify heart disease risks earlier in a woman’s life, and how to alert patients about lifestyle changes they can start making ASAP.
Heart Disease Prevention
“Heart disease is the leading killer of women in the United States,” Dr. Montgomery says. “If we could predict for women that they were going to be at risk for heart disease, and if we could have them begin a healthier lifestyle 20 years ahead of time, then we could bend the curve.”
There is no foolproof way to predict high blood pressure during pregnancy, especially for a woman whose blood pressure was previously normal. But there are things you can do to prevent it from happening in the first place. “One of the biggest factors is BMI,” Dr. Faubion says. “If women are going in at higher risk, they’re overweight [or] maybe have high blood pressure, and the biggest thing they can do is try to work on fitness, maintain a healthy weight, and exercise regularly.”
If you’re currently going through a tough menopause, look back at your pregnancy experiences. Did you ever have gestational hypertension? These two factors–menopause symptoms and high blood pressure during pregnancy–could be signs that you’re at high risk for heart disease. “Identifying that history is important for [women] going forward,” Dr. Faubion says. Tell your primary care doctor so they can include this information in your cardiovascular risk assessment.
“If we know information and we act on that information, it gives you the opportunity to change the curve and to be a healthier you for longer,” Dr. Montgomery adds. He suggests several lifestyle changes to promote heart health, including adopting a regular exercise program, scheduling consultations with a cardiologist, keeping an eye on your blood pressure, and maybe going on blood pressure medication (if your doctor approves it).
It all boils down to this: What happens during pregnancy certainly doesn’t end when you give birth. “I think the real take-home message is that we really need to pay more attention to what happens during pregnancy as a predictor of lifelong health in women,” Dr. Montgomery says. These little clues can be like pieces of the puzzle to better understand your body, and to take action that will help you live a longer, happier life.
Pregnancy Blood Pressure Disorders: Centers for Disease Control and Prevention. (n.d.) “High Blood Pressure During Pregnancy.” cdc.gov/bloodpressure/pregnancy.htm
Menopause & Gestational Hypertension Study: Menopause. (2020.) “Hypertensive disorders of pregnancy and menopausal symptoms a cross-sectional study from the data registry on experiences of aging, menopause, and sexuality.” journals.lww.com/menopausejournal/Abstract/9000/Hypertensive_disorders_of_pregnancy_and_menopausal.97106.aspx
Hot Flashes & Blood Vessel Function: Menopause. (2018.) “Physiologically assessed hot flashes and endothelial function among midlife women.” journals.lww.com/menopausejournal/Abstract/2018/11000/Physiologically_assessed_hot_flashes_and.25.aspx
Gestational Hypertension & Heart Disease Risk: Annals of Internal Medicine. (2018.) “Hypertensive Disorders of Pregnancy and Maternal Cardiovascular Disease Risk Factor Development.” acpjournals.org/doi/10.7326/M17-2740
Preeclampsia: American College of Obstetrics and Gynecology. (n.d.) “Preeclampsia and High Blood Pressure During Pregnancy.” acog.org/patient-resources/faqs/pregnancy/preeclampsia-and-high-blood-pressure-during-pregnancy
Heart Disease: Centers for Disease Control and Prevention. (n.d.) “Women and Heart Disease.” cdc.gov/heartdisease/women.htm