9 February 2021

A number of specific conditions in women are important in their risk of cardiovascular disease. These include high blood pressure during pregnancy, gestational diabetes and early menopause. Experts from various fields, from the Radboudumc among others, are calling for better alertness to high blood pressure in middle-aged women, as this is still too often not treated properly.

In this international guideline, now published in European Heart Journal, cardiologists, gynecologists and endocrinologists from several European hospitals advise on women-specific risk factors that may influence cardiovascular disease risk over the life course.

Early menopause

For example, women who go through early (natural) menopause before the age of 40 are more likely to have cardiovascular disease. Each year the risk of this increases by three percent. Autoimmune diseases such as rheumatoid arthritis and lupus are more common in women than in men and also increase the risk of cardiovascular disease.

Effects of high blood pressure during pregnancy

High blood pressure in pregnancy and, in particular, pre-eclampsia/HELLP, increases the risk of cardiovascular disease twice and the risk of high blood pressure four times, often at an early age. To identify high blood pressure in time, the authors recommend for these high-risk women to take regular blood pressure measurements at home.

Angela Maas, Professor of Women's Cardiology and first author of the article: "High blood pressure during pregnancy is a warning sign that a woman may develop hypertension later, often many years before menopause. It leads to an increased risk of dementia, heart damage, kidney problems and a higher risk of stroke. If high blood pressure is not treated until years later, it is much harder to get it right with medication."

Prevention and getting there earlier

More and more is becoming known about the importance of diet and lifestyle for high blood pressure. This is also true for women, as Angela Maas, also founder of Hart voor Vrouwen, points out. But she also argues that a different view of women with high blood pressure is needed. "Almost half of women have hypertension by the age of 60. It causes many symptoms in middle age, such as chest pain, pain between the shoulder blades, hot flashes, insomnia, cardiac arrhythmia and hot flashes. These are symptoms that are often wrongly attributed to menopause. The detection of hypertension in middle-aged women must be intensified."


Publication in European Heart Journal: Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists – Angela H.E.M. Maas, Giuseppe Rosano, Renata Cifkova, Alaide Chieffo, Dorenda van Dijken, Haitham Hamoda, Vijay Kunadian, Ellen Laan, Irene Lambrinoudaki, Kate Maclaran, Nick Panay, John C. Stevenson, Mick van Trotsenburg, Peter Collins. DOI: 10.1093/eurheartj/ehaa1044.

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