Gynecology and Your Heart Health

By Jane Farrell

Annual “well woman” exams by OB/GYNs give an opportunity to evaluate another area of women’s health: heart health, according to a new joint advisory from the American College of Obstetricians and Gynecologists (ACOG) and the American Heart Association.

The advisory stresses the benefits of collaborative care between OB/GYN specialists and cardiologists.

As heart disease and stroke continue to be the leading causes of death in women, the advisory notes the essential role OB/GYNs play in actively helping women reduce their risk, since approximately 90 percent of women have at least one risk factor for heart disease and stroke, according to a news release from the AHA.

“OB/GYNs are primary care providers for many women, and the annual ‘well woman’ visit provides a powerful opportunity to counsel patients about achieving and maintaining a heart-healthy lifestyle, which is a cornerstone of maintaining heart health,” said John Warner, M.D. president of the American Heart Association, executive vice president for Health System Affairs at University of Texas Southwestern Medical Center in Dallas, Texas.

Traditional risk factors for heart disease — such as high blood pressure, diabetes, high cholesterol and obesity — affect both sexes but some may affect women differently and are considered to be more significant.

OB/GYN’s are uniquely qualified to identify and treat woman-specific conditions and treatments that may raise a woman’s risk of heart disease or stroke. Complications of pregnancy, including preeclampsia, gestational diabetes, gestational hypertension, pre-term delivery, and low-for-estimated-gestational-age birth weight all indicate a subsequent increase in the mother’s cardiovascular risk.

“As the leading healthcare providers for women, OB-GYNs provide care that goes far beyond reproductive health and are in a unique position to screen, counsel and educate patients on heart health. By acknowledging and discussing the risks and communicating steps women can take to reduce their odds of developing heart disease. OB-GYNs have a powerful opportunity to be the secret weapon in the fight against heart disease,” said Haywood L. Brown, M.D., immediate past president of the American College of Obstetricians and Gynecologists (ACOG) and F. Bayard Carter Professor in the department of obstetrics and gynecology at Duke University Medical Center in Durham, North Carolina.

Adverse pregnancy outcomes can be used to identify women who are at an increased risk for heart disease, even in those for whom the conditions resolve after delivery. Preeclampsia and gestational hypertension impart a three- to six-fold excess of subsequent hypertension and a two-fold risk for subsequent heart disease.

As cardiovascular disease continues to be the leading cause of death in women, the advisory provides recommendations on how cardiologists and OB/GYN providers can work collaboratively, using both low-tech solutions, such as advising patients about healthy diet and lifestyle at every visit, and high-tech solutions such as software algorithms that can trigger patient education and referrals by analyzing data contained in electronic medical records.

By providing a platform for comprehensive well-woman care, primary prevention and early intervention, providers of women’s health can provide patient education, empowerment and motivation.